• UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
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  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
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Urinary Fistulas: Understanding & Expert Repair in Dallas-Fort Worth

Finding Relief from Persistent Leaks at Urology Partners of North Texas (UPNT)
Experiencing a urinary fistula—an abnormal connection causing continuous urine leakage—can be incredibly distressing and disruptive. In the Dallas-Fort Worth Metroplex, this challenging condition requires specialized expertise for accurate diagnosis and effective repair. At Urology Partners of North Texas (UPNT), we expertly diagnose and surgically correct urinary fistulas, offering personalized care to restore your comfort and quality of life.
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What is a Urinary Fistula? Understanding the Abnormal Connection

A urinary fistula is an abnormal opening or passageway that forms between a part of the urinary tract (like the bladder, ureter, or urethra) and another organ or the skin. This means urine can bypass its normal route and leak into another body area or directly outside the body. This persistent, uncontrolled leakage can be devastating for a patient’s comfort and daily activities.

How Urinary Fistulas Can Happen:

Urinary fistulas often arise as a complication of medical procedures or underlying health conditions.
  • Most Common Cause: Surgery:
  • Gynecologic Surgeries: Hysterectomies and other pelvic surgeries are the most frequent cause, sometimes leading to connections between the bladder and vagina (vesicovaginal fistula) or ureter and vagina (ureterovaginal fistula).
  • Bowel or Colon Surgery: Procedures involving the intestines can sometimes lead to fistulas between the bowel and bladder (enterovesical fistula).
  • Prostate Surgery (in Men): While less common, prostatectomy can, in rare instances, lead to fistulas.
  • Radiation Therapy: Radiation treatment for pelvic cancers (e.g., cervical, prostate, rectal cancer) can damage tissues over time, leading to breakdown and fistula formation months or even years later.
  • Inflammation or Infection: Severe infections (like diverticulitis) or inflammatory conditions (like Crohn's disease) can erode tissue, creating a connection between organs.
  • Trauma: Accidental injury (e.g., from car accidents, pelvic fractures, or penetrating wounds) can directly damage tissues and lead to fistula formation.
  • Cancer: The growth of a tumor can erode through tissue, creating an abnormal opening.

Types of Urinary Fistulas We Expertly Diagnose and Treat

Urinary fistulas are named based on the organs they connect. At UPNT, we have extensive experience diagnosing and treating various types.
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Common Urinary Fistula Types Include:

  • Vesicovaginal Fistula: An abnormal opening between the bladder and the vagina. This is one of the most common types, typically resulting in continuous urine leakage from the vagina.
  • Ureterovaginal Fistula: A connection between the ureter (tube from kidney to bladder) and the vagina, also causing continuous urine leakage from the vagina.
  • Enterovesical Fistula: An abnormal connection between the bowel (intestine) and the bladder. This can cause air or stool to pass into the urine, along with recurrent UTIs.
  • Urethrovaginal Fistula: An opening between the urethra (tube from bladder to outside) and the vagina, leading to urine leakage through the vagina.
  • Rectovesical Fistula (in Men): A connection between the rectum and the bladder, allowing stool or gas to pass into the bladder and urine to leak.
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Recognizing the Signs: Symptoms of a Urinary Fistula

The symptoms of a urinary fistula can be distressing and often include continuous leakage of urine, but they vary depending on where the abnormal connection is located.

Key Symptoms You Might Experience:

  • Continuous Urine Leakage: This is the most common and often the most bothersome symptom. Unlike stress or urge incontinence, the leakage is often constant and not necessarily tied to physical activity or bladder urges.
  • Urine Leakage from the Vagina (for women): This is highly indicative of a vesicovaginal or ureterovaginal fistula.
  • Passage of Gas or Stool in Urine (Pneumaturia or Fecaluria): A strong sign of an enterovesical (bowel-to-bladder) fistula. You might see bubbles or even fecal matter in your urine.
  • Recurrent Urinary Tract Infections (UTIs): Frequent and persistent UTIs that are difficult to treat, especially with enterovesical fistulas.
  • Irritation of External Genitalia/Skin: Constant urine leakage can irritate the skin.
  • Abdominal Pain or Discomfort: May be present depending on the underlying cause or location.
  • Foul-Smelling Urine:Especially with enterovesical fistulas.

Precise Diagnosis of Urinary Fistulas at UPNT: Getting to the Root of the Problem

Diagnosing a urinary fistula requires careful investigation and a high level of expertise to pinpoint the exact location and nature of the abnormal connection. At Urology Partners of North Texas in the Dallas-Fort Worth Metroplex, our specialists are highly experienced in identifying and characterizing even complex fistulas.

Our Thorough Diagnostic Process Typically Includes:

  • Detailed Medical History & Symptom Discussion: We begin with an in-depth conversation about your symptoms, prior surgeries, radiation history, and any relevant medical conditions.
  • Physical Exam: A careful physical examination, often including a pelvic exam for women, to look for signs of leakage or abnormal openings.
  • Dye Tests:
  • Tampon Test (for women): A blue dye is placed in the bladder, and tampons are inserted into the vagina. Blue staining on the tampon indicates a bladder-to-vagina fistula.
  • Oral Dye Test: For suspected ureteral fistulas, an oral dye that is excreted by the kidneys can be given.
  • Lab Tests: Urinalysis and urine culture to check for infection.
  • Lab Tests: Urinalysis and urine culture to check for infection.
  • Advanced Imaging Studies (In Collaboration with DFW's Leading Centers):
  • While we focus on evaluation within our clinics, we partner closely with the finest imaging centers across the Dallas-Fort Worth Metroplex to obtain the most precise images.
  • CT Scan with Contrast (CT Urogram/CT Enterography): These detailed scans, performed at our trusted imaging partners in DFW, are crucial for visualizing the urinary tract and identifying abnormal connections, especially enterovesical fistulas.
  • Cystogram: Dye is filled into the bladder, and X-ray images are taken to show leakage outside the bladder.
  • MRI: May be used for detailed soft tissue visualization, especially for complex or difficult-to-locate fistulas.
  • Cystoscopy (and Collaboration for Other Endoscopic Views):
  • Cystoscopy: Our specialists perform this minimally invasive procedure to directly visualize the inside of the bladder and urethra, looking for the fistula opening.
  • For suspected bowel-related fistulas (like enterovesical), we work closely with expert colorectal or GI specialists who can perform procedures like flexible sigmoidoscopy to visualize the bowel side of the connection, ensuring a complete and accurate diagnosis.
  • Urodynamics (If Related Bladder Dysfunction is Suspected):
  • In some cases, urodynamics testing may be performed at UPNT to assess overall bladder function, especially if associated bladder weakness or overactivity is present.

Expert Management & Treatment for Urinary Fistulas at UPNT

Treating urinary fistulas is a specialized area of reconstructive urology that demands precision and experience. At Urology Partners of North Texas, our primary goal is to successfully close the fistula, restore normal urinary function, and alleviate your symptoms. Our DFW experts offer a range of solutions, meticulously chosen based on the fistula’s type, size, location, cause, and your overall health.

Our Personalized Management & Treatment Approaches Include:

  • Conservative Management (For Small, Select Cases):
  • Sometimes, for very small, non-cancerous fistulas, a temporary bladder catheter (for continuous drainage) and antibiotics (to control infection) might be attempted, allowing the fistula to potentially close on its own.
  • Endoscopic Repair:
  • For certain small or simple fistulas, minimally invasive endoscopic techniques can be used to attempt closure from inside the bladder.
  • Surgical Repair (Open or Minimally Invasive):
  • The Most Common & Definitive Treatment: Surgical repair is typically the most effective and durable treatment for urinary fistulas. The goal is to close the abnormal opening and separate the organs involved.
  • The Most Common & Definitive Treatment: Our urological surgeons are highly experienced in performing complex reconstructive procedures for urinary fistulas. They are skilled in both traditional open approaches (when necessary for complex cases) and advanced minimally invasive techniques, including.
  • UPNT Expertise in Complex Reconstructive Surgery: Our urological surgeons are highly experienced in performing complex reconstructive procedures for urinary fistulas. They are skilled in both traditional open approaches (when necessary for complex cases) and advanced minimally invasive techniques, including robotic-assisted surgery. This expertise allows for precise dissection, meticulous closure, and optimal outcomes, helping to ensure the best chance for successful repair.
  • Simultaneous Correction: Often, the underlying cause (like a bladder outlet obstruction) is addressed during the same surgery to prevent recurrence.

Why Choose Urology Partners of North Texas for Urinary Fistula Care in DFW?

Dealing with a urinary fistula calls for precise diagnosis and a skilled approach to repair. At Urology Partners of North Texas, we offer individuals across the Dallas-Fort Worth area experienced care for urinary fistulas.
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  • DFW's Skilled Reconstructive Urologists: Our urological surgeons possess deep, specialized knowledge and extensive experience in reconstructive urology, with a proven track record in repairing many types of urinary fistulas. We have the expertise to diagnose and fix most of these complex conditions.
  • Precise Diagnostic Capabilities: We excel at accurately identifying the exact location and nature of your fistula using advanced diagnostic tools and close collaboration with DFW's top imaging centers, ensuring a clear understanding of your condition.
  • Comprehensive Surgical Skill Set: Our team is proficient in a full range of repair techniques, from endoscopic approaches to complex open and robotic-assisted surgeries. This means we have the right expertise for your specific fistula.
  • Dedicated to Restoring Quality of Life: We understand the profound impact a fistula has. Our care is focused not just on closing the opening, but on restoring your normal urinary function, comfort, and daily life.
  • Personalized & Empathetic Approach: We provide caring support, clear explanations, and a treatment plan uniquely tailored to your needs, guiding you through every step of your journey to healing.
  • A Trusted Name in DFW Urology: As a cornerstone of urological care in the Dallas-Fort Worth area, UPNT is committed to serving our community with integrity, scientific excellence, and a steadfast commitment to helping you find lasting relief.

Frequently Asked Questions (FAQs) About Urinary Fistulas

Here are answers to common questions our patients in Dallas-Fort Worth often ask about urinary fistulas:
What is the most common cause of a urinary fistula?
The most common cause of urinary fistulas is typically prior surgery in the pelvic area, such as gynecologic procedures (like hysterectomy) or bowel surgeries, where unintended connections can form between the urinary tract and other organs.
The most common symptom is continuous, involuntary urine leakage. Depending on the fistula’s location, you might also experience urine leaking from the vagina (in women), gas or stool in your urine, recurrent UTIs, or abdominal discomfort.
While very small, simple fistulas (sometimes aided by continuous bladder drainage via a catheter) might occasionally close on their own, most urinary fistulas, especially larger or more complex ones, require surgical repair for definitive and lasting closure.
Our diagnosis involves a detailed history, physical exam, specialized dye tests, and advanced imaging (like CT scans or cystograms performed with DFW imaging partners). Cystoscopy (looking inside the bladder) is also a key diagnostic step, and we collaborate with GI specialists for bowel visualization when needed.
Surgical repair of a urinary fistula is generally considered a complex reconstructive procedure. It requires specialized surgical skill to close the abnormal connection and ensure normal anatomy is restored. Our UPNT surgeons have extensive experience in these intricate repairs, often using minimally invasive techniques.
An enterovesical fistula is an abnormal connection between your bowel (intestine) and your bladder. It often results from conditions like diverticulitis, inflammatory bowel disease (Crohn’s), or prior bowel surgery, causing symptoms like gas or stool in the urine and frequent UTIs.

Take the Next Step Towards Relief & Healing. Contact UPNT Today.

If you are experiencing symptoms of a urinary fistula, or have received a diagnosis and are seeking expert evaluation and repair in Dallas-Fort Worth, reach out to Urology Partners of North Texas. We are here to provide clear understanding, specialized care, and effective solutions to help you regain comfort and improve your quality of life.
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