Treatment
Urinary Fistula

The treatment of urinary fistula is complex and will usually require surgical reconstruction.

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Treatments for urinary fistulas

Some fistulas may require only conservative therapy. However, most fistulas need surgical intervention to repair them.

Conservative therapy

Some simple fistulas may heal on their own. This may be possible when the fistula is small and the surrounding tissue is healthy. For example, when the tissue has not been damaged by radiation therapy or cancer.

To cure the fistula, the doctor may try to help the person's urinary tract work properly without urine passing through the fistula. Some patients may have to use a urinary catheter to drain the bladder. People with a ureterovaginal fistula may have a small catheter (tube that holds the ureter open) placed in the ureter. This catheter can help urine flow properly from the kidneys to the bladder while the fistula heals.

Surgery

Most fistulas require surgical repair. The type and location of the fistula will determine the type of surgery. Some surgeries are performed through the vagina and others through the abdomen. Some cases can be corrected with laparoscopic surgery, which uses small incisions, or robotic surgery, which allows very precise movements.

The goal of surgery is to repair the fistula so that healthy tissue can grow and close the opening of the fistula, restoring normal function to the affected organs. The surgeon will work to remove the damaged tissue and any other matter, such as a tumor, that may be affecting the fistula.

Before surgery, the doctor will work to make the tissue in the area of the fistula as healthy as possible. This may include medications or wound care to help the tissue heal.

If the fistula is large and involves the bowel or colon, your doctor may recommend a colostomy before surgery. This procedure will keep the fistula clear for surgery. Once the fistula area heals, the physician can usually remove the colostomy.

After surgery, most patients will have a catheter in their bladder for a few weeks. The catheter can be removed once the fistula area has healed.

Find out more about

Urinary Fistula

Symptoms and causes Diagnosis Outcomes and quality of life

They ask us

in the Consultation

I have been diagnosed with a urinary fistula, which specialist should treat me?

First of all, an evaluation by a urologist specializing in reconstructive urology should be performed. He or she will adequately evaluate the patient's condition in order to propose an individualized treatment.

I expel gases through the urinary tract, is it serious? 

The expulsion of gases through the urine may indicate the existence of a fistula of the urinary tract and the digestive tract. This is a communication between the two. In itself it is not serious. It may be associated with an increase in urinary tract infections. A proper study of the origin of the fistula is necessary, which may be related to urological processes such as previous surgeries or digestive processes such as infections or diverticulitis.

What happens if I have a urinary fistula and do not have surgery?

In case of urinary fistula, either with the vagina or the gastrointestinal tract, involuntary urine leakage or gas emission through the urethra may occur. If not operated, these symptoms do not disappear. Occasionally, fistulas may close spontaneously by placing a bladder catheter, but surgical intervention is usually required.

How long does it take for a urinary fistula to heal? 

If the fistulas are not operated, the probability of spontaneous healing is low, although sometimes they can close with the placement of a bladder catheter. However, the time required is not short, requiring several weeks.

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