The Department of Obstetrics and Gynecology in King Abdulaziz Medical City – Jeddah in collaboration with Health Promotion Services held the 2015 Vaginal Fistula Awareness day under the slogan "We are all with you for the treatment of vaginal fistula". The event lasted for two days in King Abdulaziz Medical City - Jeddah, which aimed to increase the community awareness about the vaginal fistula as a disease and to increase the awareness levels of the families about the suffering experienced by the patients. Dr. Fatmah Noorwaly, an OB-GYN, Urology and Pelvic Consultant pointed out that Vaginal Fistulais divided into:
Vesicovaginal Fistula (bladder fistula):
Refers to an abnormal connection between the bladder and the vagina which lead to involuntary urinary leakage. Some of its causes is difficult childbirth or the entrapment of the baby's head in the vagina, however, relevant cases has been almost reduced except in poor countries that lack hospitals and healthcare centers. Moreover, modern causes of bladder fistula could be complications of Caesarean sections and often after repeated operations or complex Hysterectomy procedures where the bladder may rupture. This type of fistula is diagnosed by the bladder speculum, the use of colored dye to know the size of the fistula and the extent in which its attached to the ureter, CT scans to show the possibility of damage to the ureter and the bladder with the fistula, as well as a urinalysis and not using a permanent catheter to reduce infections.
Rectovaginal Fistula (rectal fistula):
Refers to an abnormal connection between the vagina and the lower portion of the large intestine (rectum) which leads to involuntarily exit of stool and gases from the vagina. Some of its causes is rectum damage during childbirth, cancer, or Crohn's disease and the cause must be known before initiating any surgical procedures. This type of fistula is diagnosed by the Blue dye test, in which the dye is injected into the rectum and to show if there is leakage from the vagina thus knowing the presence of a fistula and how many leakage openings. MRI is also used in diagnosing this type to show the contact size between the colon and the vagina, the number of openings and making sure there is no cancer in the pelvic area. Another way to diagnose is using rectal ultrasound waves to evaluate the rectal muscle.
In addition, Dr. Fatmah Noorwaly pointed out that 8 cases of bladder fistula and 10 cases of rectal fistula have been treated via laparotomy in King Abdulaziz Medical City – Jeddah. Now for the first time, bladder fistula has been treated via a microscope on a 30 year old woman who suffered from bladder fistula for 8 months after a caesarean sections. The patient recovered after 15 days.
Dr. Fatima also noted that a medical symposium was held to discuss topics related to this disease, as well as holding an Awareness Day in the Outpatient Center at King Abdulaziz Medical City -Jeddah to educate patients and visitors.