The World Health Organization reports between 50,000-100,000 women suffer from an obstetric fistula every year. The half a million Americans who have Crohn’s disease are also susceptible to fistulas. Despite so many people being affected by fistulas every year, not many people know about them or how they are treated.
What is a fistula?
A fistula is a pathway that has formed between two organs or vessels that do not usually connect. The most common types of fistula are:
- Intestinal fistula: Abnormal connection between an intestine and the skin or a neighboring organ
- Obstetric fistula: Abnormal connection between the vagina and the rectum or urinary tract
- Anal fistula: Abnormal connection between the anus and the skin
- Urinary tract fistula: Abnormal connection between a urinary tract organ and other organ
What are the symptoms of a fistula?
Symptoms of a fistula include:
- Involuntary urine or stool leakage
- Foul-smelling discharge from the urethra or anus
- Fever, if infection is present
Can you live with a fistula?
If left untreated, fistulas can lead to infections and other serious complications. Some fistulas can be treated with antibiotics or other medication. If a fistula does not respond to medication, or if it is severe enough to deem an emergency, surgery is required for treatment.
How does fistula surgery work?
Fistula surgery is done under general anesthesia. You will need transportation arrangements to and from the surgery facility. There are several surgical approaches to repair a fistula, these include:
- Medical Plug: Your doctor will insert a medical-grade plug into the fistula to close it and allow it to heal.
- Drain Insertion: Your doctor will place a thin, surgical cord, called a seton, into the fistula to allow it to drain the infection and promote healing.
- Fistula Opening: Your doctor will make a small incision along the length of the fistula to allow it to heal.
- Medical Glue: Your doctor will apply medical-grade glue to the fistula to close it and promote healing.
- Ileostomy: If you have a fistula resulting in stool entering the intestine, your doctor may perform an ileostomy to bring the small intestine up to the wall of the stomach. Stool will exit through the stomach and into a medical pouch that can be emptied and cleaned. This is often a temporary situation to allow the fistula to heal.
- Fistulotomy: If you have an anal fistula your doctor may perform a fistulotomy, which repairs the fistula without damaging the anal sphincter muscles.
The fistula surgery you have will depend on the cause of your fistula, such as labor and delivery or Crohn’s. Fistula surgery will be recommended by your doctor based on the location and severity of your fistula.
Fistula surgery recovery time
Typically, you can go home the same day as fistula surgery. Most people return to work 1-2 weeks after surgery. The wound from the fistula or incision site usually heals in 4-6 weeks but may take up to 9 weeks to fully heal.
Precautions to be taken after fistula surgery
Most fistula surgeries today are performed through minimally invasive laparoscopic techniques which use small incisions and slender instruments. Minimally invasive approaches result in faster recovery times, however there are still precautions that need to be taken. After fistula surgery, you may need to use a urinary catheter for a short period of time to ensure proper bladder function. Your doctor may also prescribe stool softeners after surgery. Bowel movements after fistula surgery may be difficult or painful, and a stool softener can make the passage of stool easier. Your doctor will work with you to create a recovery plan unique to your surgery and healing.
Ways of preventing fistula
Preventing fistulas is the best form of treatment. Maintaining a healthy diet promotes healthy tissue and helps ward off fistulas. Avoiding smoking can also promote healthy tissue and aid in fistula healing.
How do I find a fistula surgeon near me?
When searching for a fistula surgeon near you, make sure the doctor is board-certified and specializes in the area of concern. Doctors who specialize in minimally invasive surgery techniques will be able to provide you with treatment options that require smaller incisions and shorter recovery times.
If you are experiencing any symptoms of a fistula, it is important to schedule an appointment with a doctor. If left untreated, fistulas can result in infections and other serious complications. Fistulas are treatable, typically do not require an overnight stay at a hospital, and the recurrence rate is generally low. Don’t suffer with the painful and unpleasant symptoms of a fistula any longer. Schedule an appointment with a doctor today.