Bladder fistula – symptoms to look out for and how to treat

A bladder fistula is when a hole forms between the bladder and another part of the body. While it only happens in rare cases, a urinary fistula might form after childbirth or if the bladder has been injured or operated on. So, if you have recently given birth, had surgery on or torn part of the lower body, there is a chance of a fistula. 

The symptoms (see lower down) don’t always include extreme pain, but a bladder fistula can cause a lot of unease and will need treating by a health professional. Urinary and faecal leakages are signs of a bladder fistula and should not be ignored. And while our products take care of leakages, if you think you have a medical problem, it’s important to seek help.  

Here, we will look at the different types of fistulas, the symptoms to look out for and how to go about getting the help you need. 

What is a bladder fistula?

A bladder fistula refers to a hole or ‘opening’ that has formed between the bladder and another organ or the skin. This hole in the body can cause urine to leak from the bladder through to the area on the other side of the opening. Sometimes, the leaking is barely noticeable. Other times, there might be a steady leakage, depending on the size of the opening inside the body. 

Any kind of leakage can feel embarrassing, but seeking professional help and wearing bladder leakage products can help tackle the issue in the meantime.

What are the symptoms of a bladder fistula?

General symptoms of a bladder fistula include: 

  1. Abdominal pain 

  2. Discomfort when urinating 

  3. Your urine starts smelling like or looking cloudy, muddy or like stool, and it may contain pus or faeces 

  4. Gas or faeces comes out when you are peeing 

Check out our guide to the different urine smells to help decipher your symptoms. If you are experiencing frequent UTIs or the urge to pee a lot, it could also be the result of a bladder fistula.  

Types of fistulas

There are several different types of fistulas. The type of fistula and the symptoms you will notice depend on the part of the body affected. 

While any fistula is rare, here are two types that can occur and what to note about each. 

1. “Bladder to vagina” or vesicovaginal fistula 

A “vesicovaginal fistula” is an opening – sometimes more than one – between the bladder and the wall of the vagina. With this type of fistula, the vagina will leak urine uncontrollably because the vagina is not able to hold or store urine. 

2. “Bladder to bowel” or enterovesical fistulas

An “enterovesical fistula” is a change to the connection between the bladder and a part of the bowel. 

There are different types of enterovesical fistula (and enterovesical fistula symptoms), and it is not easy to diagnose. But when detected, it is diagnosed based on the part of the bowel concerned. It might be the connection between the bladder and the intestine or the bladder and the colon.  

Types of enterovesical fistula including a “colovesical fistula” mean that stool, pus or blood can seep from the fistula opening. Early signs are swelling or a lump in the anal area, as well as pain or irritation that worsens when you sit down, move around, pass stool or cough.  

Causes of a bladder fistula

There are many reasons a fistula might develop. Some people are even born with the condition. Here are some of the causes: 

  1. A difficult childbirth 

  2. Radiotherapy or surgery

  3. Inflammation 

  4. A bad urinary infection 

  5. A form of cancer, such as bowel cancer 

  6. A pre-existing health conditions including Crohn's disease and diverticulitis (sometimes referred to as a “diverticular fistula”) 

Whatever the case, if you notice that you are experiencing the symptoms of a bladder fistula, you will need expert medical attention. 

Bladder fistula treatment: how to seek help

Getting tested

It will first need to be determined if you do have a urinary fistula. Or perhaps there is another reason for your symptoms, such as a UTI. 

These are the ways you will most likely be tested for a fistula: 

  • A urine test 

  • An examination of the vagina 

  • Swab testing 

Examination under anaesthetic (EUA), X-rays, CT scans, radiological imaging and MRI scans can also be used to determine whether urine has entered parts of the body where it should not be. 

Getting the help you need

Depending on the diagnosis you receive, you will discuss your treatment with a medical professional. It is important to be honest and open about your symptoms. 

1. Catheters

When the condition is caught in its early stages, a catheter is a common bladder fistula treatment (without surgery). The leaking urine is taken in by the insertion of a catheter, which collects and drains the urine. With this treatment, the bladder fistula might even heal by itself. 

2. Bladder fistula surgery 

Treatment for the urinary fistula is often surgical. With this method, the damaged tissue is taken away and any openings are stitched together. If the problem persists, another surgical procedure might be needed. 

Depending on where in the body the fistula is, the surgery will take a different form. The surgery might go in through the vagina, the tummy – or in some instances, you might need keyhole surgery to repair the damage. The type of procedure needed will be decided by your doctor. 

There are many reasons why you might have bladder fistula symptoms or another type of urinary discomfort. You could have a vesicovaginal fistula or another medical condition. Knowing about the causes of incontinence can help ease a racing mind, as can a visit to your GP for an expert diagnosis. 

While seeking and undergoing treatment, be sure to stock up the incontinence products, so you can continue with your everyday life. TENA makes discreet and absorbent products for conditions like a bladder fistula. And we’ve partnered with Bladder and Bowel UK to encourage anyone with issues to get the help they need.