Urinary & Rectal Fistulas

A fistula is an abnormal opening or connection between one organ (such as the bladder) and another organ (such as the colon or vagina). 

Rose Khavari, MD, a Houston Methodist urologist, explains what urogenital fistulas are, their symptoms and how they are diagnosed and treated.

Several types of urinary fistula occur:

  • Vesicovaginal fistula - between the bladder and the vagina
  • Vesicouterine fistula - between the bladder and the uterus
  • Urethrovaginal fistula - between the urethra and the vagina
  • Ureterovaginal fistula - between the ureter and the vagina
  • Colovesical fistula - between the colon (bowel) and the bladder
  • Rectovaginal fistula - between the rectum and the vagina

Causes of Urinary and Rectal Fistulas
Common causes of urinary and rectal fistulas include the following:
  • Childbirth (the most common cause), caesarean section or episiotomy
  • Injury to the organs in question, either during surgery or through trauma
  • Injury to the bladder during abdominal or pelvic surgery, such as hysterectomy
  • Pelvic malignancy, such as cervical or colon cancer
  • Radiation therapy
  • Inflammatory disease, such as Crohn’s disease
  • Disease of the large intestine (including diverticulitis )

Symptoms of Urinary and Rectal Fistulas
Symptoms of urinary and rectal fistulas vary, though you may experience some of the following:
  • Constant urine leakage from the vagina
  • Irritation in the area of the vulva
  • Frequent urinary tract infections
  • Leakage of gas or stool into the vagina
  • Fluid drainage from the vagina
  • Diarrhea
  • Abdominal pain
  • Fever
  • Weight loss
  • Nausea
  • Vomiting

Treating Urinary and Rectal Fistulas
Because a fistula is an unwanted connection or tunnel between two organs, the treatment for most fistulas is surgical repair. Most commonly, the fistula is closed by using adjacent tissues for the repair. Occasionally, other tissues have to be used for coverage of complex wounds.
These issues can impact your quality of life but can be resolved. Your first step is to talk with one of our specialists.

Houston Methodist combines the expertise of urogynecologists — specialty physicians trained in the areas of urology and gynecology — as well as traditional gynecologists and colorectal surgeons to provide the most advanced care available for women and men with problems related to the lower urinary tract and the pelvic floor. The Center for Restorative Pelvic Medicine at Houston Methodist Hospital is the first of its kind in the Greater Houston area and is one of the few centers in the country that offers a single-center location for the diagnosis and treatment of complex pelvic-floor disorders.


Our physicians at Houston Methodist specialize in treating urinary and rectal fistulas at the following convenient locations.