Pelvic Fistulas

Pelvic fistulas in women refer to pathological communications between the urinary or gastrointestinal tract and the genital organs. The majority of urogenital fistulas relate to obstetric or postsurgical complications, less often to pelvic malignancy and radiation therapy. Anovaginal and rectovaginal fistulas result from obstetric trauma, including prolonged labor and perineal lacerations, whereas inflammatory bowel diseases account for fewer cases. A wide range of examinations, including intravenous urography, cystography, cystoscopy, barium enema, hysterosalpingography, fistulography, computed tomography (CT) and magnetic resonance imaging (MRI) have been used successfully in the evaluation of intrapelvic fistulous communications. In recent
The location of the connective tract defines the type of pelvic fistula. Urogenital fistulas refer to abnormal communications between the female genital tract and the bladder, urethra, or ureters. The types encountered are vesicovaginal, vesicouterine, ureterovaginal and urethrovaginal, either obstetric or postsurgical, based on pathogenesis. Anovaginal, rectovaginal, colovaginal and enterovaginal fistulas are pathological communications that connect the lower gastrointestinal tract with the vagina. At last, a communication between the gastrointestinal and the urinary tract leads to the formation of the least common types of fistulas, namely ureteroenteric and vesicoenteric fistulas. Pelvic fistulas are usually the consequence of obstetric complications, such as uterine rupture or prolonged labor, contraceptive devices that are misplaced, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes (1). More rare cases of fistulas have been described after uterine artery embolization or rupture of cystic adenomyoma (2,