The symptoms of vaginal fistulas include leakage of urine or feces through the vagina. Symptoms of anal and rectal fistulas, if caused by an abscess, include constant throbbing pain and swelling in the rectal area. Pus is sometimes visible draining from the fistula opening on the skin. Many individuals have a fever resulting from the infection causing the abscess.
A thorough history usually identifies risk factors that may lead to a vaginal fistula, such as recent pelvic surgery, infection, or prior radiation. An initial exam usually includes a pelvic exam with a speculum. Additional diagnostic testing may include dye tests, cystoscopy, retrograde pyelograms, fistulagrams and other imaging studies as needed.