Can feces from the urethra or vagina in women mean a fistula?

Question

Hello doctor,

I have had severe stomach pain and diarrhea for the last two weeks. For many years, I have experienced frequent farts from my urethra or vagina. They smell exactly like farts that should only come out of the anus. During my menstruation, menstrual blood comes from my anus, especially when I poop.

Today, when I was urinating, I saw a grape-sized poop in the toilet bowl, and I suspect the poop is coming out of my urethra. May I know if it is due to a fistula? If it is a fistula, what is the type of fistula? If I do not go for surgery, will it lead to cancer?

Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

As per your description, it looks like a rectovesical fistula (a connection between your rectum and urinary bladder). Rectovesical fistulas are less common in females as the uterus comes in between. As you are also passing blood from the rectum during your menstrual period, it means there is a connection between the rectum, uterus, vagina, and urinary bladder (both rectovaginal and rectovesical fistula).

A rectovesical and rectovaginal fistula usually does not occur without any pathology. The reasons for rectovesical fistula are:

1. A recent history of any pelvic surgery.

2. Pelvic malignancies like rectal cancer or urinary bladder cancer.

I would like to know whether there is any history of fecal matter from the vagina, and whether there is a history of weight loss. Is there any bleeding from the rectum during the passage of stools other than during menstruation? Is there hematuria (blood in urine)?

I suggest you consult a colorectal or gynecological surgeon as soon as possible.

I hope this will help you.

Kindly revert in case of further queries.

Thank you.