Obstetric and Gynecological Nursing - The Carter Center

• May be obvious or extremely difficult to identify, and
photocopy or the introduction of dyes may be
required.
Treatment
The treatment of all fistulae, except small fistulae which have
formed recently following child birth or operation, is surgical.
Some recently formed vesico vaginal fistulae will heal if the
bladder is drained continuously for 21 to 28 days and some
recto vaginal fistulae will heal if a low residue diet is given for
the some period. Most fistulae require operation.
The principles involved are;
A. the fibrosed edges of the fistulous tract must be excised
so that well vascularized viable tissue may be brought in
to apposition
B. the apposition must be effected with out tension on the
apposed edges
C. The tissues must not be placed under tension for at least
3 weeks (this principle implies constant bladder drainage
in cases of vesicovaginal fistulae)
D. The best results are obtained if fistulae are treated in
special units, where experience in the operative technique
and, more important, the meticulous postoperative
management of the case can be offered.
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