Pelvic Fistula Specialist

Dr. Daniel Stone, MD FACOG

Urogynecologist located in Phoenix, AZ

Dr. Daniel Stone, MD is one of the leading experts in the surgical management of pelvic fistulas. Dr. Stone can diagnosis and provides management options for pelvic fistulas to patients in the Phoenix, Scottsdale and surrounding Arizona areas. By correcting this extremely bothersome condition, women can get back to their normal life.

Pelvic Fistula Q&A

  • What is Fistula and what are the different types of pelvic fistulas?

    Fistulas are an abnormal connection between two body parts that aren’t normally connected. These divided into the following groups:

    • Genitourinary Fistulas
      • Vesicovaginal – Connection between the bladder and vagina.
      • Urethovaginal – Rare connection between urethra and vagina.
      • Vesicouterine – Rare connection between bladder and uterus.
      • Vesicocervical – Rare connection between bladder and cervix.
      • Ureterovaginal - Connection between the ureter and vagina
    • Rectovaginal Fistulas – Connection between the rectum and vagina
    • Colovaginal Fistulas – Connection between the colon and vagina. These fistulas are treated by colorectal surgeons.

  • What are the symptoms of a pelvic fistula?

    Genitourinary fistulas present as constant urinary leakage from the vagina. Rectovaginal fistulas present as accidental bowel leakage from the vagina, air escaping from the vagina, vaginal infections, or bad-smelling vaginal discharge.

  • Why do fistulas form?

    They form due to damage to the tissue. Depending on the cause of this tissue damage, fistulas can form within days to years. The causes of pelvic fistulas are listed below:

    • Childbirth – Very long periods of labor can lead to tissue damage and fistulas. This can lead to rectovaginal, vesicovaginal or urethrovaginal fistulas.
    • Surgery -  Pelvic fistulas are a complication of pelvic surgery including hysterectomies, and reconstructive vaginal surgery.
    • Cancer – Pelvic fistulas can occur due to cancer itself or due to radiation that is used to treat cancer. These types of fistulas are very difficult to treat due to the poor tissue quality caused by the radiation.
    • Foreign Bodies -  Any type of foreign body that is left in place can lead to tissue damage and fistula formation. Pessaries, when left in place for a long time, can lead to fistulas in rare circumstances.
    • Chronic bowel conditions: Diverticulitis or inflammatory bowel disease (Crohns or Ulcerative colitis) can lead to tissue damage and fistula formation. Although Dr. Stone can assist in the diagnosis of fistulas, he does not treat fistulas due to chronic bowel conditions and instead would set you up with a colorectal surgeon and GI doctor.

  • How are Genitourinary Fistulas diagnosed?

    Dr. Stone will ask you about your symptoms and when they started and then perform a pelvic exam. Sometimes he may place special dyes into the bladder to determine where the leakage is coming from. He may recommend other tests as well such as a cystoscopy or CT scan.

  • How are Genitourinary Fistulas treated?

    Depending on the size, location, and reason for the fistula, Dr. Stone will discuss different options with you. If the fistula is small, the placement of a catheter for 4-6 weeks may help the fistula to close on its own. A ureterovaginal fistula is present, a ureteral stent can help with healing.

    If those options don’t work, or it is a large fistula, then surgery would be required. 98% of Dr. Stone’s surgeries result in a successful resolution of the fistula. Surgery can be done vaginally, or robotically depending on the location of the fistula. After surgery, you will need a urinary catheter for 1-2 weeks.

Vesicovaginal Fistula
  • How are Rectovaginal Fistulas diagnosed?

    Dr. Stone will ask you about your symptoms and when they started and then perform a pelvic exam. Dr. Stone may use dye to help see the fistula if it is small. Sometimes a small metal probe is used to locate the fistula if it is hard to find. Occasionally, Dr. Stone will order and perform a transanal ultrasound to determine if the fistula involves the anal sphincters.

  • How are Rectovaginal Fistulas treated?

    Depending on the cause, size, and location, Dr. Stone will discuss several options with you. If the cause of the injury was recent, he may discuss watching and waiting to see if the tissue can heal with time. If you have inflammatory bowel disease, medications can help with healing and reducing inflammation.

    Dr. Stone’s success rate for surgery is around 95% to resolve the symptoms. Dr. Stone performs this surgery vaginally. The surgery involves removing the fistula tract and bringing together the different layers of tissue. Sometimes, Dr. Stone will use a graft from the surrounding tissue to help with healing.

Rectovaginal Fistula

Testimonials

Debra
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"He actually took the time and listened to me. After the exam he told me that he wanted to try another pessary before committing to surgery. He fit one in and it worked! I haven't felt this good in years. I'm so so grateful to him!"
Madeline
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"He is one of the most caring docs I've ever been to. I've been struggling with this problem for years and have been to 3 docs before I saw him."
Sandy
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"Dr. Stone is a really good doctor. After I had the urethra sling surgery Dr Stone called me at home to see how I was doing. The office staff is good. Dr Stone's nurse Iris is really good she returns calls. I will refer my family and friends to this office."
Debra
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"Dr. Stone has been wonderful. I was very hesitant at first to see a man but he put me completely at ease. I was able to speak to him about my problem with leakage. He discussed several options and gave me choices which I loved. Eventually I decided on surgery. The surgery went well and I finally have my life back again."
Tina
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"I highly recommend him. I will be referring all my loved ones if ever they develop problems."
Betsy
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"He put us at ease about the surgery by really explaining the procedure in detail to me, my husband and my daughter. He made me feel like I was his only patient."
Joyce
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"Awesome!! Would give him 10 stars!!!!! Dr. Stone took the time to fully explain medical procedures. He patiently answered all my questions."
Alice
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"His bed-side manner put me at ease discussing a very embarrassing topic. I'd recommend him to anyone."
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Major Insurance Providers Accepted

We accept most insurance policies for your convenience. Please contact your insurance carrier to verify your individual benefits and any copays or coinsurance that are part of your plan. Patients are responsible for notifying our office if a specific plan requires precertification, preauthorization, or a referral (especially HMOs). Please call the phone number on the back of your insurance card to verify your provider network participation as insurance carriers change policies often.

Schedule your appointment with Dr. Stone today

One of our staff members will contact you directly. If you have any concerns requiring immediate attention, please don’t hesitate to call us at 602-788-1521.

Dr. Stone is also offering Telemedicine visits. Call to schedule today.

Office location

Valley Urogynecology Associates

1616 East Maryland Avenue

Phoenix, Arizona 85016-1302

Office Hours: Monday-Friday from 8 AM – 5 PM

Main: (602) 788-1521

Fax: (602) 688-5420

Conveniently located just off Highway 51 on Maryland Avenue just East of 16TH Street between East Bethany Home Road and East Glendale Avenue.