What Is a Ureteral Fistula?

A ureteral fistula is the abnormal adhesion of a bodily structure to a ureter, which is the tube that transports urine from the kidney to the bladder. A fistula is an abnormal connection or opening between an organ or vessel and another bodily structure, and usually occurs as a result of surgery, injury, childbirth, disease, or infection. A ureteral fistula is a type of urinary fistula, which is an abnormal connection between an organ of the urinary tract and another organ or structure. In the case of a ureteral fistula, it is the ureter that has formed a connection to an organ or structure.

There are many different types of urinary fistulas. An arterial ureteral fistula, or anterio-ureteral fistula, is a communication between an artery and the middle or lower part of a ureter, which can cause hematuria or blood in the urine. A vaginal ureteral fistula, better known as a ureterovaginal fistula (IVF), is the abnormal connection of a ureter to the vagina, which may cause urine to leak from the vaginal opening.

There are other common urinary fistulas that don't involve either of the ureters. The vesicouterine fistula is a connection between the bladder and the uterus. The urethrovaginal fistula is a communication between the vagina and the urethra, which is the tube that drains urine from the bladder and is found in both males and females. The colovesical fistula is a connection between the colon or bowel and the bladder, while a rectovaginal fistula joins the rectum to the vagina.

The most common cause of a fistula is surgery or injury. A vasicovaginal fistula, which is a connection between the bladder and the vagina, is the most common type of urinary fistula. It is usually caused by an injury to the bladder during surgery. Other causes of urinary fistulas include, cancer, radiation therapy, and inflammatory disease like Crohn's disease.

Symptoms of a fistula vary depending on what part of the body and which organs are affected. Generally a ureteral fistula can cause pains in the side, fever, chills, nausea, vomiting, abdominal pain, and the abnormal passage of blood, urine, or feces. Diagnosis typically includes a pelvic exam by a medical practitioner and one or more tests such as magnetic resonance imaging (MRI), ultrasound, computer tomography (CT or CAT) scan, or cytoscopy. Treatment for a fistula usually involves surgical repair and prescription antibiotics if the condition is accompanied by an infection.