A fistula is an abnormal connection between two hollow spaces, such as blood vessels or intestines. Types include anal fistulas, anovaginal fistulas, and colonovaginal fistulas. Urinary tract fistulas are abnormal openings or connections between organs. They can result from infection, inflammation, injury, or surgery. Treatment varies, often involving surgical intervention and antibiotic therapy. In some cases, the fistula is temporarily covered with fibrin glue or plug, and catheters may be needed to drain the fistula.


      1.Anal Fistula:

  • Pain or discomfort around the anus.
  • Swelling or a lump near the anus.
  • Recurrent anal abscesses.
  • Pus or fluid discharge from the opening near the anus.

      2. Anovaginal or Rectovaginal Fistula:

  • Passage of gas or stool through the vagina.
  • Vaginal discharge with an unpleasant odor.
  • Recurrent urinary tract infections.
  • Irritation and discomfort in the vaginal area.

       3. Colovaginal Fistula:

  • Passage of gas or stool through the vagina.
  • Vaginal discharge.
  • Abdominal pain or discomfort.

      4. Urinary Tract Fistula (e.g., Vesicovaginal Fistula):

  • Urinary incontinence (involuntary leakage of urine).
  • Recurrent urinary tract infections.
  • Passage of urine through the vagina.
  • Irritation or discomfort in the genital area.

      5.Enteroenteral, Enterocutaneous, and Colocutaneous Fistulas:

  • Abdominal pain or cramping.
  • Malnutrition or weight loss.
  • Skin infections or irritation if the fistula opens on the skin.


  1. Infections: Infections weaken tissues, forming abscesses, which can accumulate pus, creating tunnels and eventually fistulas, such as anal fistulas.
  2. Inflammatory Conditions: Chronic inflammation in conditions like Crohn’s disease increases the risk of fistula development due to tissue damage, erosion, and abnormal connections, affecting the gastrointestinal tract.
  3. Trauma: Physical injuries, trauma, and surgeries can cause tissue and organ damage, leading to fistula formation during healing.
  4. Underlying Medical Conditions: Inflammatory bowel diseases like Crohn’s and ulcerative colitis increase fistula risk due to medical conditions.
  5. Surgical Complications: Surgical procedures can cause unintended consequences like fistulas due to poor wound healing, infection, or organ proximity during surgery, aiming to heal and repair.
  6. Congenital Factors: Some individuals are born with conditions that make them more prone to fistulas. For example, congenital conditions like tracheoesophageal fistulas are present from birth and involve an abnormal connection between the trachea and esophagus.
  7. Chronic Irritation or Pressure: Prolonged irritation or pressure on tissues can lead to tissue breakdown and the formation of openings or tunnels. This can occur in areas of the body where there’s consistent friction or pressure, such as between the rectum and the vagina.
  8. Medical Interventions: In some cases, medical interventions involve intentionally creating fistulas for specific purposes. For example, arteriovenous fistulas can be surgically created to facilitate hemodialysis treatment for individuals with kidney failure.


Some fistulas are easy to spot. Others aren’t. Doctors may examine anus for signs of oozing fluid or bleeding, and may stick a finger into the anus during an exam.

Doctor may refer you to a specialist for colon and rectal problems, including exams, imaging tests, and colonoscopy. They may also insert a camera tube into your anus to examine the bowels while you sleep.


1. Conservative Management:

  • For some small and uncomplicated fistulas, conservative management might involve antibiotics to treat any associated infections and promote healing.
  • Pain management and wound care may also be included in the conservative approach.          

2. Surgical Intervention:

  • Surgical closure is often necessary for complex or persistent fistulas. Surgical procedures aim to close the abnormal connection and promote healing of the surrounding tissues.
  • The specific surgical technique used depends on the location and complexity of the fistula. Procedures may involve cutting out the fistula tract, repositioning tissues, and suturing the affected area.

3. Fibrin Glue or Plugs:

  • In some cases, a fibrin glue or plug may be used to temporarily seal the fistula tract. This approach is often used in less complex fistulas and can help promote healing.

4. Seton Placement:

  • A seton is a piece of material (such as a rubber band or surgical thread) that is placed through the fistula tract to keep it open. This approach is sometimes used to allow the fistula to drain and heal gradually, reducing the risk of complications.

5. Medical Therapy:

  • In certain cases, medical therapy such as immunosuppressive drugs or medications that reduce inflammation might be used, especially for individuals with underlying conditions like Crohn’s disease.

6. Catheter Drainage:

  • In cases where continuous drainage is necessary, such as with some urinary tract fistulas, a catheter may be inserted to facilitate the drainage of fluids until the fistula can be treated or managed more definitively.

7. Colostomy or Diversion:

  • In complex cases, where the fistula is difficult to treat or if there’s a risk of complications, a temporary colostomy or urinary diversion may be performed. This involves rerouting the stool or urine away from the affected area to allow it to heal.

8. Lifestyle Modifications:

  • Depending on the type of fistula, lifestyle changes like dietary adjustments and proper hygiene practices might be recommended to prevent complications and promote healing.




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