[header] How to diagnose a fistula [title] Check for pain around the anus or genitals. [step] Pain and irritation are common symptoms of many types of fistulas. You may experience pain and swelling around anus, genitals, or the area between the genitals and anus (the perineum). 
[substeps] Anal fistulas may cause pain during bowel movements. Fistulas involving the vagina may cause pain during sexual intercourse.