An abnormal connection between the urinary tract and a nearby organ, correctable with surgery. A urinary fistula can cause distressing, continuous leakage of urine, but with careful assessment and skilled repair the problem can usually be put right. Dr. Anish Gupta diagnoses and treats urinary tract fistulae in Delhi NCR.
What is a urinary tract fistula?
A fistula is an abnormal channel that forms between two organs or spaces that are not normally connected. A urinary tract fistula links part of the urinary system — such as the bladder or ureter — to a neighbouring organ like the vagina, bowel or skin. Because urine can then escape through this abnormal connection, it may leak continuously or appear where it should not, such as into the vagina or the bowel.
Fistulae are uncommon, but they can be physically uncomfortable and emotionally difficult to live with. The good news is that most can be corrected surgically once they are accurately identified.
Symptoms
Symptoms depend on which organs are involved, but often include:
- Continuous, uncontrolled leakage of urine, often without warning
- Urine passing from the vagina (in a bladder- or ureter-to-vagina fistula)
- Air, cloudy urine or bowel content in the urine (in a bladder-to-bowel fistula)
- Repeated urinary infections
- Skin irritation from constant dampness
- An unpleasant smell that is hard to control
Causes and risk factors
Urinary fistulae usually develop after damage to the urinary tract. Common causes include:
- Complications of pelvic or gynaecological surgery, such as a hysterectomy
- Prolonged or obstructed childbirth
- Radiotherapy to the pelvis
- Inflammatory bowel disease or diverticular disease affecting the bowel
- Pelvic injury or, rarely, advanced pelvic cancers
When to see a urologist
See a urologist if you have continuous urine leakage, notice urine passing from the vagina, or find air or unusual material in your urine — especially after pelvic surgery, childbirth or radiotherapy. Repeated urinary infections that will not settle can also be a clue. Early assessment allows the fistula to be mapped accurately and treated, easing symptoms and preventing infections and skin problems from continuing.
How it is diagnosed
Diagnosis aims to confirm the fistula and pinpoint exactly where it is. Dr. Anish Gupta may arrange:
- A careful examination and review of your history, including any recent surgery
- A urine test to check for infection
- A cystoscopy to look inside the bladder
- Specialised imaging and dye tests to trace the abnormal connection
- Detailed scans arranged through our urology diagnostics service
Treatment options
Treatment depends on the size, location and cause of the fistula. The aim is to close the abnormal connection and restore normal urinary control.
Initial and conservative measures
Any infection is treated first, and the skin is protected. Occasionally a very small, recent fistula may be managed initially with catheter drainage to allow it a chance to heal, while symptoms are controlled and the situation is assessed.
Surgical repair
Most urinary fistulae are corrected with surgery to close the abnormal channel and separate the two organs, sometimes reinforcing the repair with healthy tissue. Depending on the type and location, this may be done through a minimally-invasive or an open approach. When infection or inflammation is present, surgery is usually timed to give the tissues the best chance of healing well.
Treating the underlying cause
Where a fistula is linked to bowel disease, radiotherapy or another underlying condition, that cause is addressed as part of the overall plan, often alongside colleagues in related specialties.
Why choose Dr. Anish Gupta
Dr. Anish Gupta is a Consultant Urologist & Andrologist with more than 20 years of experience in reconstructive and minimally-invasive urology. He approaches fistula care with precision and sensitivity, recognising how much these problems affect daily life, and plans each repair carefully for the best chance of a lasting result. Care is available at three locations in Delhi NCR: Ashok Vihar, Rohini and Karol Bagh.
Frequently asked questions
Can a urinary fistula heal without surgery?
Occasionally a very small, recent fistula may close on its own with a period of catheter drainage. However, most established fistulae need surgical repair to close the abnormal connection properly and stop the leakage for good.
Is a urinary fistula a common problem?
Urinary fistulae are relatively uncommon. They most often follow pelvic surgery, difficult childbirth or radiotherapy. Because they are less familiar, an accurate diagnosis by an experienced urologist is important to plan the right treatment.
Will treatment stop the leakage completely?
The goal of surgery is to close the fistula and restore normal urinary control, and results are often very good when the repair is planned carefully. The outlook depends on the size, location and cause, which Dr. Anish Gupta will discuss with you honestly.
How long does recovery take after fistula repair?
Recovery varies with the type of repair and approach used. A catheter is usually kept in place for a period afterwards to allow healing, and you will be given clear guidance on activity and follow-up so the repair has the best chance to succeed.
Every treatment plan starts with a proper assessment, so you only get the care your condition actually needs — and if the honest answer is that you don't need a procedure, you'll hear that too.