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Vaginal Fistula
Marc S. Tubay, MD; Akram M. Shaaban, MBBCh
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Epithelially lined abnormal communication between vaginal lumen and adjacent pelvic organs

          Imaging

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        Pathology

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              Clinical Issues

                              • Presentation

                                • Treatment

                                  Diagnostic Checklist

                                  • Image Interpretation Pearls

                                    • Reporting Tips

                                      Selected References

                                      1. Tonolini M: Elucidating vaginal fistulas on CT and MRI. Insights Imaging. 10(1):123, 2019
                                      2. Dwarkasing RS et al: Chronic anal and perianal pain resolved with MRI. AJR Am J Roentgenol. 200(5):1034-41, 2013
                                      3. Viswanathan C et al: Multimodality imaging of vulvar cancer: staging, therapeutic response, and complications. AJR Am J Roentgenol. 200(6):1387-400, 2013
                                      4. Abou-El-Ghar ME et al: Radiological diagnosis of vesicouterine fistula: role of magnetic resonance imaging. J Magn Reson Imaging. 36(2):438-42, 2012
                                      5. Botsikas D et al: A new MDCT technique for the detection and anatomical exploration of urogenital fistulas. AJR Am J Roentgenol. 198(2):W160-2, 2012
                                      6. Filmar GA et al: Retroperitoneal duplication cyst with a fistulous tract to the vagina: a case report. Female Pelvic Med Reconstr Surg. 18(6):376-7, 2012
                                      7. Holroyd DJ et al: Colovaginal and colovesical fistulae: the diagnostic paradigm. Tech Coloproctol. 16(2):119-26, 2012
                                      8. Hosseinzadeh K et al: Imaging of the female perineum in adults. Radiographics. 32(4):E129-68, 2012
                                      9. Kao PF et al: Vesicovaginorectal fistula on a FDG PET/CT of a patient with recurrent cervical cancer and end-stage renal disease. Clin Nucl Med. 37(10):1013-5, 2012
                                      10. Moshiri M et al: Evaluation and management of disorders of sex development: multidisciplinary approach to a complex diagnosis. Radiographics. 32(6):1599-618, 2012
                                      11. Verma A et al: Magnetic resonance fistulogram demonstration of urethrovesicovaginal fistula in a case of müllerian agenesis due to traumatic urethral coitus. J Minim Invasive Gynecol. 19(2):259-61, 2012
                                      12. Walker DK et al: Overlooked diseases of the vagina: a directed anatomic-pathologic approach for imaging assessment. Radiographics. 31(6):1583-98, 2011
                                      13. Addley HC et al: Pelvic imaging following chemotherapy and radiation therapy for gynecologic malignancies. Radiographics. 30(7):1843-56, 2010
                                      14. Paspulati RM et al: Imaging of complications following gynecologic surgery. Radiographics. 30(3):625-42, 2010
                                      15. Quiroz LH et al: Three-dimensional ultrasound imaging for diagnosis of urethrovaginal fistula. Int Urogynecol J. 21(8):1031-3, 2010
                                      16. Sofic A et al: MRI in evaluation of perianal fistulae. Radiol Oncol. 44(4):220-7, 2010
                                      17. Narayanan P et al: Fistulas in malignant gynecologic disease: etiology, imaging, and management. Radiographics. 29(4):1073-83, 2009
                                      18. Griffin N et al: Magnetic resonance imaging of vaginal and vulval pathology. Eur Radiol. 18(6):1269-80, 2008
                                      19. Lang EK et al: Urethral rectovaginal fistula assessed by magnetic resonance imaging. J Urol. 179(3):1148, 2008
                                      20. Ergen FB et al: Magnetic resonance fistulography for the demonstration of anovaginal fistula: an alternative imaging technique? J Comput Assist Tomogr. 31(2):243-6, 2007
                                      21. Hoeffel C et al: Anatomic and pathologic findings at external phased-array pelvic MR imaging after surgery for anorectal disease. Radiographics. 26(5):1391-407, 2006
                                      22. López C et al: MRI of vaginal conditions. Clin Radiol. 60(6):648-62, 2005
                                      23. Smayra T et al: Vesicouterine fistulas: imaging findings in three cases. AJR. 184:139-42, 2005
                                      24. Avritscher R et al: Fistulas of the lower urinary tract: percutaneous approaches for the management of a difficult clinical entity. Radiographics. 24 Suppl 1:S217-36, 2004
                                      25. Dwarkasing S et al: Anovaginal fistulas: evaluation with endoanal MR imaging. Radiology. 231(1):123-8, 2004
                                      26. Yu NC et al: Fistulas of the genitourinary tract: a radiologic review. Radiographics. 24(5):1331-52, 2004
                                      27. Stoker J et al: Anovaginal and rectovaginal fistulas: endoluminal sonography versus endoluminal MR imaging. AJR Am J Roentgenol. 178(3):737-41, 2002
                                      28. Kruskal JB et al: Peroxide-enhanced anal endosonography: technique, image interpretation, and clinical applications. Radiographics. 21 Spec No:S173-89, 2001
                                      29. Volkmer BG et al: Colour Doppler ultrasound in vesicovaginal fistulas. Ultrasound Med Biol. 26(5):771-5, 2000
                                      30. Semelka RC et al: Pelvic fistulas: appearances on MR images. Abdom Imaging 22:91-5, 1997
                                      31. Outwater E et al: Pelvic fistulas: findings on MR images. AJR 160:327-30, 1993
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Definitions

                                                • Epithelially lined abnormal communication between vaginal lumen and adjacent pelvic organs

                                              Imaging

                                              • General Features

                                                • Radiographic Findings

                                                  • Fluoroscopic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            Pathology

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  Clinical Issues

                                                                  • Presentation

                                                                    • Treatment

                                                                      Diagnostic Checklist

                                                                      • Image Interpretation Pearls

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Tonolini M: Elucidating vaginal fistulas on CT and MRI. Insights Imaging. 10(1):123, 2019
                                                                          2. Dwarkasing RS et al: Chronic anal and perianal pain resolved with MRI. AJR Am J Roentgenol. 200(5):1034-41, 2013
                                                                          3. Viswanathan C et al: Multimodality imaging of vulvar cancer: staging, therapeutic response, and complications. AJR Am J Roentgenol. 200(6):1387-400, 2013
                                                                          4. Abou-El-Ghar ME et al: Radiological diagnosis of vesicouterine fistula: role of magnetic resonance imaging. J Magn Reson Imaging. 36(2):438-42, 2012
                                                                          5. Botsikas D et al: A new MDCT technique for the detection and anatomical exploration of urogenital fistulas. AJR Am J Roentgenol. 198(2):W160-2, 2012
                                                                          6. Filmar GA et al: Retroperitoneal duplication cyst with a fistulous tract to the vagina: a case report. Female Pelvic Med Reconstr Surg. 18(6):376-7, 2012
                                                                          7. Holroyd DJ et al: Colovaginal and colovesical fistulae: the diagnostic paradigm. Tech Coloproctol. 16(2):119-26, 2012
                                                                          8. Hosseinzadeh K et al: Imaging of the female perineum in adults. Radiographics. 32(4):E129-68, 2012
                                                                          9. Kao PF et al: Vesicovaginorectal fistula on a FDG PET/CT of a patient with recurrent cervical cancer and end-stage renal disease. Clin Nucl Med. 37(10):1013-5, 2012
                                                                          10. Moshiri M et al: Evaluation and management of disorders of sex development: multidisciplinary approach to a complex diagnosis. Radiographics. 32(6):1599-618, 2012
                                                                          11. Verma A et al: Magnetic resonance fistulogram demonstration of urethrovesicovaginal fistula in a case of müllerian agenesis due to traumatic urethral coitus. J Minim Invasive Gynecol. 19(2):259-61, 2012
                                                                          12. Walker DK et al: Overlooked diseases of the vagina: a directed anatomic-pathologic approach for imaging assessment. Radiographics. 31(6):1583-98, 2011
                                                                          13. Addley HC et al: Pelvic imaging following chemotherapy and radiation therapy for gynecologic malignancies. Radiographics. 30(7):1843-56, 2010
                                                                          14. Paspulati RM et al: Imaging of complications following gynecologic surgery. Radiographics. 30(3):625-42, 2010
                                                                          15. Quiroz LH et al: Three-dimensional ultrasound imaging for diagnosis of urethrovaginal fistula. Int Urogynecol J. 21(8):1031-3, 2010
                                                                          16. Sofic A et al: MRI in evaluation of perianal fistulae. Radiol Oncol. 44(4):220-7, 2010
                                                                          17. Narayanan P et al: Fistulas in malignant gynecologic disease: etiology, imaging, and management. Radiographics. 29(4):1073-83, 2009
                                                                          18. Griffin N et al: Magnetic resonance imaging of vaginal and vulval pathology. Eur Radiol. 18(6):1269-80, 2008
                                                                          19. Lang EK et al: Urethral rectovaginal fistula assessed by magnetic resonance imaging. J Urol. 179(3):1148, 2008
                                                                          20. Ergen FB et al: Magnetic resonance fistulography for the demonstration of anovaginal fistula: an alternative imaging technique? J Comput Assist Tomogr. 31(2):243-6, 2007
                                                                          21. Hoeffel C et al: Anatomic and pathologic findings at external phased-array pelvic MR imaging after surgery for anorectal disease. Radiographics. 26(5):1391-407, 2006
                                                                          22. López C et al: MRI of vaginal conditions. Clin Radiol. 60(6):648-62, 2005
                                                                          23. Smayra T et al: Vesicouterine fistulas: imaging findings in three cases. AJR. 184:139-42, 2005
                                                                          24. Avritscher R et al: Fistulas of the lower urinary tract: percutaneous approaches for the management of a difficult clinical entity. Radiographics. 24 Suppl 1:S217-36, 2004
                                                                          25. Dwarkasing S et al: Anovaginal fistulas: evaluation with endoanal MR imaging. Radiology. 231(1):123-8, 2004
                                                                          26. Yu NC et al: Fistulas of the genitourinary tract: a radiologic review. Radiographics. 24(5):1331-52, 2004
                                                                          27. Stoker J et al: Anovaginal and rectovaginal fistulas: endoluminal sonography versus endoluminal MR imaging. AJR Am J Roentgenol. 178(3):737-41, 2002
                                                                          28. Kruskal JB et al: Peroxide-enhanced anal endosonography: technique, image interpretation, and clinical applications. Radiographics. 21 Spec No:S173-89, 2001
                                                                          29. Volkmer BG et al: Colour Doppler ultrasound in vesicovaginal fistulas. Ultrasound Med Biol. 26(5):771-5, 2000
                                                                          30. Semelka RC et al: Pelvic fistulas: appearances on MR images. Abdom Imaging 22:91-5, 1997
                                                                          31. Outwater E et al: Pelvic fistulas: findings on MR images. AJR 160:327-30, 1993