Obstetric and Gynecological Nursing - The Carter Center

ecto vaginal fistula. Other types may occur, but are rare, and
occasionally multiple fistulae may be found in the same
woman.
Cause: In developing countries
- about 85% of fistulae follow an obstructed labour
- 15% surgery or radiation for gynecological conditions
Obstetrical and surgical fistulae arise either immediately due
to direct trauma, or 5 to 14 days after delivery or operation
when the traumatized, ischaemic tissue sloughs. Fistulas
following irradiation rarely appear until one or more years after
treatment.
- In vesico vaginal fistulae
• the patient complains incontinence of urine
• urinary incontinency is continuous night and day
• If the fistula is large, the defect can be seen, but pin
point fistulae may require special tests for diagnosis.
One such special test is to place three cotton wool
swabs in the vagina, one above the other, and to run
methyl lene blue dye into the bladder.
• if only the lowest swab stains the fistula is urethral
• if the middle swab stains, it is vesical
• if no swab stains but the upper most swab is wet, the
fistula is ureterial.
• In recto vaginal fistulae
• The patient complain incontinence of faeces
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