Urogynecologist Juraj Letko, MD, consults with a patient seeking treatment for a pelvic floor condition

Effective fistula treatment requires advanced care with an experienced team of specialized urogynecologic surgeons. At the University of Chicago Medicine, our experts will design a personalized plan to repair your fistula and improve your quality of life.

What is a Fistula?

A fistula is an abnormal connection between two organs and can occur in any part of the body. In the pelvis, fistulas usually form between the vagina and either the urinary tract (bladder, urethra and/or ureters) or the gastrointestinal (digestive) tract (rectum, colon and/or small bowel). A fistula can also form between the gastrointestinal tract and the urinary tract without involving the vagina.

What are Fistula Symptoms?

Pelvic fistulas can cause distressing and embarrassing problems, like uncontrollable leakage of urine or stool from the vagina. Complex fistulas can develop when multiple organs are involved and, in these cases, urine, gas and stool can leak through the vagina.

Other symptoms of pelvic fistulas may include:

Types of Fistulas and Causes

Testing and Diagnosis for Fistulas

Your urogynecologic surgeon may suspect a fistula based on your medical history and a comprehensive physical exam. Additional tests are often needed to confirm the diagnosis and identify the type of fistula, which is critical to successfully treat your symptoms.

Some of the diagnostic tests available include:

  • Radiologic Imaging:
  • Computer tomography (CT) of the abdomen and pelvis, typically with contrast (dye) that is given vaginally and rectally
  • Magnetic resonance imaging (MRI), typically with contrast that is given vaginally and rectally
  • Barium enema X-ray of the abdomen after filling the colon with a liquid contrast
  • Cystoscopy: An in-office exam looking inside the bladder and the urethra with a thin camera
  • Anoscopy: An in-office exam of the anus and the rectum
  • Colonoscopy: An exam of the rectum and colon with a flexible camera, usually done under sedation (“twilight”) or general anesthesia

Treatment for Genitourinary and Rectovaginal Fistulas

Fistulas do not usually heal on their own. In most cases, surgery is needed to correct the problem and should only be performed by a urogynecologic surgeon with specialized training in fistula repair.

Fistula repair surgery involves removing the fistula tract and repairing affected organs so they are no longer connected. It can be successfully performed using minimally invasive techniques (laparoscopic, robotic and through the vagina) to enhance healing and recovery. Whenever possible, treatment of the underlying cause of the fistula should occur before surgery to maximize its success.

Our Fistula Treatment Specialists

At UChicago Medicine, our fellowship-trained urogynecologic surgeons are experts in fistula repair. The Center for Pelvic Health also brings together experts from multiple specialties, including urogynecology, colorectal surgery, urology and radiology to provide coordinated care for our patients who have more complicated cases requiring a multidisciplinary approach.