A fistula is an abnormal connection or opening between two organs, or between an organ and the skin, that are not normally connected. Fistulas can occur in different parts of the body, although they are most commonly found in the pelvic region.

Fistulas are an uncommon complication of cancer or certain cancer treatments, such as surgery or radiotherapy. They may also develop when a tumour grows and invades nearby organs.

Symptoms depend on the location of the fistula. Common symptoms include:

  • Involuntary leakage of urine through the vagina or, less commonly, through another abnormal opening.
  • Passage of stool or gas through the vagina.
  • Persistent or unpleasant-smelling vaginal discharge.
  • Repeated urinary tract infections.
  • Skin irritation or discomfort in the affected area.

Diagnosis

The tests required to confirm a fistula depend on the affected area and the symptoms present. These may include:

  • Computed Tomography (CT scan).
  • Magnetic Resonance Imaging (MRI scan).
  • Contrast X-rays or other specialised investigations.
  • Physical examination and assessment by specialist healthcare professionals.

Treatment

Treatment depends on:

  • The cause of the fistula.
  • Its size and location.
  • Your overall state of health.
  • The presence of associated infection or inflammation.

Depending on the situation, treatment may include:

  • Management of infections and symptoms.
  • Skin care and measures to reduce discomfort and minimise the impact on daily life.
  • Procedures or surgery to close the fistula when this is possible.

Recovery can be slow and, in some people, the fistula may not close completely. Even so, it is often possible to control symptoms and improve quality of life.

Emotional Impact

Living with a fistula can be challenging both physically and emotionally. It is normal to feel embarrassed, worried or concerned that other people may notice the symptoms.

Talking to your healthcare team, family members or trusted friends can help you cope with the situation and identify sources of practical and emotional support.