Aa
Possible Vesicovaginal Fistula?
Hi, I had a hysterectomy in May 2007. About 6 weeks post op, I stared experiencing what I thought was yeast and bacterial infections. I also noticed that I had a very watery yellow discharge that would test positive for leukocytes and protein. Finally, after several rounds of yeast meds and BV meds, I marched into my GYN in October 2007 and said I knew it didn't have yeast or BV, it had to be something else, he confirmed that I actually had a "tissue protrusion in the vaginal cuff" and proceeded to burn it with Silver Nitrate. It took 3 visits but my symptoms did go away.
About 11 months later (September 2008) I began again with what I thought was a yeast infection. I went to my md and was told there was nothing there. I finally bought an over the counter med and my problem went away for a few weeks. But it returned. And after several bouts of yeast meds, was not getting better. I went to a different GYN and was told there was nothing wrong, but she did notice blood in my urine and set me up with a urologist. In the mean time, I had such terrible symptoms of vaginal burning, meatus irritation, and an overwhelming need to pee which only seemed worse when I actually did urinate. I went the this GYN 3 times before she finally swabbed around my vaginal opening and determined I had some mobilincus. She put me in flagyl and sent me on my way. The flagyl helped, but did not get rid of the problem completely. I saw the urologist who did a CT of the bladder and a cystoscopy and basically said you don't have Interstitial Cystitis and I don't know why you have persistent hematuria, but we'll see you back in 6 months. Completely frustrated, I returned to my original GYN and he began a trial and error of treatments which included meds for yeast, BV, atrophic vaginitis, lichens sclerosis, desquamative vaginitis, UTI, and connective tissue disease. I've had flagyl and clindamyacin (oral and vaginal), gentian violet, boric acid, desoximethosone, estrogen, amitriptaline and baclofen cream, lidocain and hydrocortisone cream, elmiron, terconozole, macrobid, oral steriods, and steriod and lidocaine injections into the scar tissue in the vaginal cuff and around the bottom of the opening. All I know, is nothing works for long, my symptoms return within a few days, sometimes even before I've finished whatever medicine regimen I'm on.
To recap, here's what my persistent symptoms/complaints have been:
*Pain up high in vaginal cuff, noticeable when touched during exam or during intercourse, feels like an open wound
*Vaginal burning/hurting
*Urinary meatus irritation that seems to extend from bottom of meatus back into vagina
*Hematuria (present on urinalysis, trace to moderate, depending upon amount of vaginal/meatus irritation)
*Very little or no vaginal discharge, when I do, it's watery and either cloudy white or yellow
*Frequently feel "wet" when I have to urinate really bad or when I've just urinated and after I've wiped.
*Increased meatus pain and feeling of wetness when I have to urinate really bad and try to hold it
I do not have any bladder, abdomina, or flank pain. I honestly don't think the hematuria is in the urine, I think the blood is coming from my vagina and contaminating the urine specimen. When I have a lot of vaginal irritation, urinating really sets me on fire, my tissues feel raw, like they're being burned. I have asked my GYN about the possibility of another tear or maybe a fistula, but he kind of ignores it. I think the believes the urologist would have seen it with the cystoscopy, but honestly, I don't know how he saw anything at all, he spent less than 1 minute doing it. I believe all he was looking for was straie in the bladder to indicated IC, which he said I don't have. I am so tired of having this discomfort, sometimes, I hurt so bad I'm in tears because I'm burning and my meatus is so irritated. I'd even entertained the idea of being allergic to my husband, as sex seemed to flare my symptoms up, but I've since ruled that out as my symptoms flare up even when I'm not having sex. I think the that little "spot" that hurts in the vaginal cuff gets irritated during intercourse and maybe leaks or drains and that's what begins the vaginal tissue irritation. I don't know, all I do know is there is no way I have a yeast or bacteria that could possible survive all the meds I've treated for. As for any UTI, when I have a bad "flare up" of vaginal burning and meatus irritation, I will have a lot of stuff in my morning urine (leukocytes, nitrites, protein, ketones, blood) but all that will go away in a few hours, leaving only the red blood, which is always there, so I don't think I've really had a UTI.
What I believe, is that I have some type of fistula. My doctor described that first occurrence as a "tissue protrusion", okay, what was it protruding through? He can't seem to see anything now, but I know a fistula can be so small you can't see it, especially if its high in the vaginal cuff. I also have a lot of scar tissue up there, according to my GYN, couldn't he be overlooking it? Sorry I"ve rambled, but I am so miserable I'm getting desperate. I didn't like the urologist I went to so I'm not sure where to go at this point for help, and I'm terrified of being told there's nothing wrong when there most definitely is.
I appreciate any help/advice you can give me.
Sincerely,
Shannon
About 11 months later (September 2008) I began again with what I thought was a yeast infection. I went to my md and was told there was nothing there. I finally bought an over the counter med and my problem went away for a few weeks. But it returned. And after several bouts of yeast meds, was not getting better. I went to a different GYN and was told there was nothing wrong, but she did notice blood in my urine and set me up with a urologist. In the mean time, I had such terrible symptoms of vaginal burning, meatus irritation, and an overwhelming need to pee which only seemed worse when I actually did urinate. I went the this GYN 3 times before she finally swabbed around my vaginal opening and determined I had some mobilincus. She put me in flagyl and sent me on my way. The flagyl helped, but did not get rid of the problem completely. I saw the urologist who did a CT of the bladder and a cystoscopy and basically said you don't have Interstitial Cystitis and I don't know why you have persistent hematuria, but we'll see you back in 6 months. Completely frustrated, I returned to my original GYN and he began a trial and error of treatments which included meds for yeast, BV, atrophic vaginitis, lichens sclerosis, desquamative vaginitis, UTI, and connective tissue disease. I've had flagyl and clindamyacin (oral and vaginal), gentian violet, boric acid, desoximethosone, estrogen, amitriptaline and baclofen cream, lidocain and hydrocortisone cream, elmiron, terconozole, macrobid, oral steriods, and steriod and lidocaine injections into the scar tissue in the vaginal cuff and around the bottom of the opening. All I know, is nothing works for long, my symptoms return within a few days, sometimes even before I've finished whatever medicine regimen I'm on.
To recap, here's what my persistent symptoms/complaints have been:
*Pain up high in vaginal cuff, noticeable when touched during exam or during intercourse, feels like an open wound
*Vaginal burning/hurting
*Urinary meatus irritation that seems to extend from bottom of meatus back into vagina
*Hematuria (present on urinalysis, trace to moderate, depending upon amount of vaginal/meatus irritation)
*Very little or no vaginal discharge, when I do, it's watery and either cloudy white or yellow
*Frequently feel "wet" when I have to urinate really bad or when I've just urinated and after I've wiped.
*Increased meatus pain and feeling of wetness when I have to urinate really bad and try to hold it
I do not have any bladder, abdomina, or flank pain. I honestly don't think the hematuria is in the urine, I think the blood is coming from my vagina and contaminating the urine specimen. When I have a lot of vaginal irritation, urinating really sets me on fire, my tissues feel raw, like they're being burned. I have asked my GYN about the possibility of another tear or maybe a fistula, but he kind of ignores it. I think the believes the urologist would have seen it with the cystoscopy, but honestly, I don't know how he saw anything at all, he spent less than 1 minute doing it. I believe all he was looking for was straie in the bladder to indicated IC, which he said I don't have. I am so tired of having this discomfort, sometimes, I hurt so bad I'm in tears because I'm burning and my meatus is so irritated. I'd even entertained the idea of being allergic to my husband, as sex seemed to flare my symptoms up, but I've since ruled that out as my symptoms flare up even when I'm not having sex. I think the that little "spot" that hurts in the vaginal cuff gets irritated during intercourse and maybe leaks or drains and that's what begins the vaginal tissue irritation. I don't know, all I do know is there is no way I have a yeast or bacteria that could possible survive all the meds I've treated for. As for any UTI, when I have a bad "flare up" of vaginal burning and meatus irritation, I will have a lot of stuff in my morning urine (leukocytes, nitrites, protein, ketones, blood) but all that will go away in a few hours, leaving only the red blood, which is always there, so I don't think I've really had a UTI.
What I believe, is that I have some type of fistula. My doctor described that first occurrence as a "tissue protrusion", okay, what was it protruding through? He can't seem to see anything now, but I know a fistula can be so small you can't see it, especially if its high in the vaginal cuff. I also have a lot of scar tissue up there, according to my GYN, couldn't he be overlooking it? Sorry I"ve rambled, but I am so miserable I'm getting desperate. I didn't like the urologist I went to so I'm not sure where to go at this point for help, and I'm terrified of being told there's nothing wrong when there most definitely is.
I appreciate any help/advice you can give me.
Sincerely,
Shannon
Hi Shannon,
I am experiencing very similar symptoms. I was wondering if you have gotten a diagnosis? Also have you found ways to manage it? I have gone through all the same tests with similar results and have yet to get rid of the burning and urgency.
Any advice at all would be great.
Thank you!
I am experiencing very similar symptoms. I was wondering if you have gotten a diagnosis? Also have you found ways to manage it? I have gone through all the same tests with similar results and have yet to get rid of the burning and urgency.
Any advice at all would be great.
Thank you!
Have you been checked for Vaginal Atrophy. I have it and it sounds a lot like this..
Dear Shannon38,
I actually just had a vesicovaginal fistula repaired. Your symptoms do not match mine at all. Of course, this could be due to the position of the fistula so I will share what I do know. A vesicovaginal fistula occurs when there is a hole between the bladder and the vagina. Mine occured after an abdominal hysterectomy which is a common cause. Childbirth is also a primary cause. With this condition, urine travels from the bladder to the vagina instead of exiting the body through the normal urinary tract. You lose all control of the flow of urine and are forced to either wear adult diapers or have a catheter in place. The urine did not cause any irritation of my vagina or other areas. It simply left me totally incontinent. It is a distressing condition and causes a great deal of shame and frustration but does not sound at all like the condition you are experiencing. I sincerely hope you find a doctor who can help you with your problem and hope my experience is somewhat helpful to you.
I actually just had a vesicovaginal fistula repaired. Your symptoms do not match mine at all. Of course, this could be due to the position of the fistula so I will share what I do know. A vesicovaginal fistula occurs when there is a hole between the bladder and the vagina. Mine occured after an abdominal hysterectomy which is a common cause. Childbirth is also a primary cause. With this condition, urine travels from the bladder to the vagina instead of exiting the body through the normal urinary tract. You lose all control of the flow of urine and are forced to either wear adult diapers or have a catheter in place. The urine did not cause any irritation of my vagina or other areas. It simply left me totally incontinent. It is a distressing condition and causes a great deal of shame and frustration but does not sound at all like the condition you are experiencing. I sincerely hope you find a doctor who can help you with your problem and hope my experience is somewhat helpful to you.
Hi Shannon38,
Hi, sorry for delay in response. This will need to be addressed by either urology or gynecology forums of Medhelp, I'm going to contact admin and have them swing your post over there. Hang in there, they'll get back to you shortly!
Good luck, I am hopeful you'll find the info you need!
Sher
Hi, sorry for delay in response. This will need to be addressed by either urology or gynecology forums of Medhelp, I'm going to contact admin and have them swing your post over there. Hang in there, they'll get back to you shortly!
Good luck, I am hopeful you'll find the info you need!
Sher
Have an Answer?
You are reading content posted in the Urology Community
Discharge often isn't normal, and could mean an infection or an STD.
Dr. Jose Gonzalez-Garcia provides insight to the most commonly asked question about the transfer of HIV between partners.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
