Female Urinating Problem

Patient: I know this sounds crazy, but it feels as if I am urinating from my vagina and has been for a while. I remember urinating from my urethra when I was younger, but I feel since becoming sexually active about 5 years ago I urinate from my vagina. When I urinate while having a tampon in, the tampon immediately enlarges like it was dipped in a cup of water but it is never a dark yellow color. In the last year I have had 2-3 yeast infections and BV twice and I was wondering if this urinating problem could be causing those? What could be wrong with me? I have read some on maybe having a fistula, but what causes them?

Doctor: It seems you may indeed have a fistula. A fistula is abnormal connection between two organs, in this case your urinary t ract and your reproductive tract (Urogenital Fistula). To determine what may have caused this fistula, the exact location must first be determined. Some causes of urogenital fistulas:Prolonged ChildbirthC-Section deliveryTumorsPelvic surgery (removal of uterus, removal of fibroids, surgery on rectum or colon)See your doctor for a complete evaluation. Identification of the fistula quite often suggests the underling factor.