Effective fistula treatment requires advanced care with an experienced team. At the Center for Pelvic Health, 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 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, both urine and gas/stool can leak through the vagina.

Other symptoms of pelvic fistulas may include:

Types of Fistulas and Causes

  • Vesicovaginal fistula: A connection between the vagina and the bladder
  • Ureterovaginal fistula: A connection between the vagina and the ureter, which is the tube that drains urine from your kidneys to your bladder
  • Urethrovaginal fistula: A connection between the vagina and the urethra, which is the tube that drains the bladder as you urinate


Pelvic surgery, specifically hysterectomy, is the most common reason fistulas form between the urinary tract and the vagina. They typically develop either immediately after surgery or within one to two weeks. The main symptom is usually constant, uncontrollable leakage of urine through the vagina.

  • Enterovaginal fistula: A connection between the small intestine and the vagina
  • Colovaginal fistula: A connection between the colon (large bowel) and the vagina. Fistulas between the colon and vagina or the urinary tract commonly occur as a complication of diverticulitis, which is an infection of the diverticula in the large intestine.
  • Rectovaginal fistula: A connection between the rectum and the vagina, also called an obstetric fistula.
    •  Fistulas between the rectum and vagina are not very common in the United States, but may develop after a vaginal tear during childbirth or other causes, such as inflammatory bowel disease, cancer, and radiation therapy.
  • Fistula in-ano: An anorectal condition connecting the anal canal and the perineal skin, which surrounds the anus. Patients with inflammatory bowel disease are at risk to develop this type of fistula.

When a fistula occurs between the vagina and the gastrointestinal tract, the main symptom is the passing of gas or leakage of stool through the vagina, known as fecal incontinence.

  • Colovesical fistula: A connection between the colon and the bladder. This type of fistula may occur after surgery, radiation, or diverticulitis.

Testing and Diagnosis for Pelvic Fistulas

Your doctor may suspect a fistula based on your medical history and a comprehensive physical exam. Additional tests are often needed to confirm the diagnosis and to specify the type of fistula, which is critical to the treatment and therapeutic approach to successfully repair your fistula.

Diagnostic Tests

  • Computer tomography (CT) of the abdomen and pelvis, typically with contrast 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 suspension

An in-office exam looking inside the bladder and the urethra with a thin camera

An in-office exam of the anus and the rectum

A colonoscopy is an exam of the rectum and colon with a flexible camera, usually done under sedation or general anesthesia

Treatment for Pelvic Fistulas

Although some small fistulas can be treated conservatively, surgery is needed in most cases to definitively resolve the problem. Only a physician with specialized training in the surgical correction of pelvic fistulas should perform this surgery.

The key step during fistula repair surgery is the removal of the fistula tract and restoration of normal anatomy by repairing affected organs. This sometimes requires removing a small part of the organ, such as the bladder, ureters, or bowel.

These surgeries can be successfully done in minimally invasive ways, performed either laparoscopically or vaginally to speed up healing and recovery time. Whenever possible, treatment of the underlying cause of the fistula should be done before surgery to maximize its success.

Our Fistula Treatment Specialists

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

Meet Our Pelvic Health Team
Please make an appointment to see one of our experts for further evaluation if you or your doctor suspect you have a fistula.

Get a Second Opinion for Fistula Treatment
We also provide expert care to patients who are seeking a second opinion or require additional treatment after a failed fistula repair.

Request an Appointment

The information you provide will enable us to assist you as efficiently as possible. A representative will contact you within one to two business days to help you schedule an appointment.

You can also make an appointment with our providers by:

Scheduling a virtual video visit to see a provider from the comfort of your home

Requesting an online second opinion from our specialists 

To speak to someone directly, please call 1-888-824-0200. If you have symptoms of an urgent nature, please call your doctor or go to the emergency room immediately.


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Pelvic Health