Question

Write the etiology of various genital fistulae.

Hint:

Genital fistulae, particularly vesicovaginal and rectovaginal fistulae, are often caused by childbirth trauma, but surgical complications and radiation therapy are also significant contributors.

Answer 1

Step 1: Introduction to Genital Fistulae.
Genital fistulae are abnormal connections between the genital tract and other structures such as the bladder, rectum, or perineum. The etiology of genital fistulae varies depending on the location and the underlying cause.
Step 2: Etiology of Genital Fistulae.
The common types of genital fistulae and their causes include:
(1) Vesicovaginal Fistula (VVF):
- Most commonly caused by obstetric trauma, especially prolonged labor leading to pressure necrosis.
- Surgical complications such as during hysterectomy or cesarean section.
- Radiation therapy for pelvic cancers can cause necrosis leading to fistula formation.
(2) Rectovaginal Fistula (RVF):
- Childbirth trauma (e.g., perineal tear) during vaginal delivery.
- Pelvic surgery (especially rectal surgery).
- Crohn's disease or other inflammatory bowel diseases.
(3) Urethrovaginal Fistula:
- Caused by trauma during childbirth or pelvic surgery.
- Infection or radiation therapy.
(4) Cervicovaginal Fistula:
- Obstetric injury or surgical complications.
- Rarely associated with cancer or radiation damage.
Step 3: Conclusion.
The most common etiology of genital fistulae is obstetric trauma, but surgery, radiation therapy, and inflammatory diseases also play a significant role.