A fistula is a connection within the body between two hollow organs - birth passage (vagina) and stool passage (rectum), birth passage (vagina) and urinary bladder etc.
When the fistula occurs as a result of a complication during the process of delivery it is called an obstetric fistula.
A fistula between the vagina and urinary bladder may occur in cases of prolonged labor. This happens when the baby's head gets stuck at the opening of the womb for a long time. A fistula between the vagina and the rectum may occur during the process of delivery when a cut near the opening of the birth passage gets extended.
A fistula with the urinary bladder causes continuous dribbling of urine through the vagina. This is associated with recurrent urinary tract infections and the continuous stench of urine. A fistula involving the rectum causes passing of stools, gas or foul smelling discharge through the vagina.
Knowing the causes, appropriate obstetric management can prevent the occurrence of a fistula. In most cases the delivery is unsupervised or being performed by an inexperienced medical person.
In almost all cases, the treatment is by surgery, which is usually done from the passage below.