An obstetric fistula is a hole between the bladder and the vagina or — more rarely — between therectumand the vagina.
Obstetric fistulas are less common in the United States where emergency obstetric care is more readily available. However, in developing countries obstetric fistulas are fairly common due to pregnancy at a much younger age and the occurrence of obstructed labor which may go on for several days, without the benefit obstetric health care.
An obstetric fistula develops when the blood supply to the tissues of the vagina and the bladder (and/or rectum) is cut off during prolonged obstructed labor. The tissues die and a hole forms through which urine and/or feces pass uncontrollably. As a result, women with fistulas constantly leak urine from their vaginas and in some cases stool.
The diagnosis and surgical management of obstetric fistulas is associated with high cure rates if performed by trained gynecologic surgeons.
The resulting disorders typically include urinary or fecal incontinence, infertility, severe infections and ulcerations of the vaginal tract. Sufferers from this disorder are usually also subject to severe social stigma due to odor, perceptions of uncleanliness, a mistaken assumption of venereal disease, and the inability to have children.
Who is at Risk for Birth Related Fistulas?
Women who have had a prolonged or obstructed vaginal delivery.
Uncontrollable loss of either urine and/or feces into the vagina.
This condition is determined upon a physical examination.
Treatments for Birth Related Fistulas
Surgical Procedures – An obstetric fistula can be closed with surgery performed by a gynecologic surgeon trained in pelvic floor medicine. Fistula patients have a good chance of returning to a normal life with full control of their bodily functions.
NOTE: Information on non-obstetric fistulas is also available on this web site.