Fistulas are common problems. They affect up to 1% of the population. According to the World Health Organization (WHO), there are 2 million cases of fistula in men and women each year worldwide. About 40% of these cases occur in developing countries. In some parts of the world, such as sub-Saharan Africa, it is estimated that 50% of all adult females have had at least one episode of sexual violence.1
The most common form of fistula is called anosmia. This means “no smell.” People with anosmia usually experience no or little odor from their genitalia. This can lead to repeated occurrences of unnoticed and untreated sexually transmitted diseases (STDs). If left untreated, these STDs may advance to become life-threatening conditions.
Many people with anosmia do not seek help from a medical professional. Others have an innate sense that something is not quite right. Still others may suffer from depression or embarrassment. These factors can prevent a person from getting treatment in a timely manner, if at all.
Anosmia can result from a birth defect, an accident, physical or sexual assault, or repeated exposure to certain toxic chemicals or gases. Anosmia can also be a side effect of certain pharmaceutical drugs.
Some types of fistulas affect both males and females, while other types only affect males or females. An example of a type of fistula that affects both is called a rectovaginal fistula.
A rectovaginal fistula occurs when an infected area of the large intestine (the rectum) develops a hole and connects to the vaginal canal. This causes a person to excrete intestinal gas, feces, and bacteria from the vaginal opening. This condition is a serious complication of an obstetric trauma. This term describes a doctor’s lack of skill in the delivery process. It can also be the result of an infection or other complication.
Another type of common fistula is called a vesicovaginal fistula. This occurs when your bladder leaks urine, allowing urine to escape through your vaginal canal.
Another common type of fistula is an enteroenteric fistula. Also called an enterovaginal fistula, this condition occurs when a portion of the small intestine develops a hole and connects to the vaginal canal. As a result, intestinal gas, feces, and bacteria escape through the vaginal opening.
Another type of fistula is an enterocolic fistula. This condition is similar to the enteroenteric fistula, except that it involves the large intestine instead of the small intestine.
Another type of fistula is an enterovaginal fistula. This condition occurs when your bladder leaks urine, allowing urine to escape through your vaginal canal.
Some people are born with one of more types of fistula. Others acquire fistulas due to disease, injury, or the result of complications during surgery.
Some types of fistula can be repaired using surgery. This involves surgically closing up the fistula. Other types of fistula may not be able to be repaired.
There is no medical treatment for anosmia or parosmia.
Some fistula patients attempt to find treatment at quack clinics. Many of these so-called clinics do more harm than good. Other fistula patients are victims of unethical medical experiments or human rights violations. Still other fistula patients are used for slave labor.
If you think you may be a victim of fistula fraud or human rights abuse, contact your local law enforcement agency immediately.
If you think you may be a victim of medical malpractice, contact your state medical board. If you suspect that a doctor has harmed you as part of an experimental treatment, contact the FDA.
The following organizations may also be able to provide you with helpful information or services:
Anosmia and Parosmia Association (APA)
Parfum de Soi (PS)
Sources & references used in this article:
- Overview of anal fistula and systematic review of ligation of the intersphincteric fistula tract (LIFT) (S Alasari, NK Kim – Techniques in coloproctology, 2014 – Springer)
- Genetic and environmental factors in the etiology of esophageal atresia and/or tracheoesophageal fistula: an overview of the current concepts (JF Felix, EM de Jong, CP Torfs… – … Research Part A …, 2009 – Wiley Online Library)
- Endosonography in anorectal disease: an overview (RJF Felt-Bersma, M Cazemier – Scandinavian Journal of …, 2006 – Taylor & Francis)
- Fistula in ano: an overview (M Akhtar – JIMSA, 2012)
- Extrapulmonary tuberculosis: an overview (JR Nicholls – Acta chirurgica Iugoslavica, 2012 – doiserbia.nb.rs)
- Endosonography in benign anorectal disease: an overview (MP Golden, HR Vikram – American family physician, 2005 – aafp.org)