Fistula and Delivery

[jd11365]

I don't know if I spelled it correctly, but hopefully those of you in the medical community know what I'm speaking about. My best friend had one and had the surgery to have it removed...if that's the term. Someone told her that some women opt to have a C-Section to avoid a return of the Fistula and thus another surgery. Have you heard of this? Do you have any information I can share with my friend?

TIA!

Jamie
Mommy to Kayla
5-1-03

[phirey]

A fistula is an abnormal communication (ie tunnel) between one normal body cavity and another. Fistulae can either be congenital or as a result of infection, cancer, inflammatory processes, etc. There are many many kinds, but the ones we see in OB/GYN are most frequently holes connecting the urethra or bladder and the vagina or the rectum and the vagina. She could also have had one between the uterus and bladder, the cervix and bladder, the intestine and vagina and the abdominal cavity and the vagina. You can imagine the problems caused when these structures are connected, as urine or feces may "leak" out from the vagina...

So her surgery was not exactly to remove it, as you would a growth, but to repair the defect (ie close the hole). Depending on where it was, what caused it, and how well it healed, it would be reasonable to consider a C-section to avoid damaging the repaired area.

I did not have a fistula but have had four bladder surgeries since I was two, including one where they completely rebuilt my bladder wall. I opted for an elective primary (first-time) C-section to avoid trauma to the area. Since I am "in the business," (specifically Gyn surgery where I spend many of my days repairing urogenital defects) I weighed my risks going into it, and decided a surgical delivery would be best for both me and my daughter. I know my decision is not always a popular one.

Depending on your friend's situation, she may or may not be a good candidate for a primary section. If you can tell me what structures the fistula was between, and what caused it, I can help you more...