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What causes a fistula? After an abscess has been drained, a passage may remain between the anal gland and the skin, resulting in a fistula. If the gland does not heal, there will be persistent drainage through this passage. If the outside opening of the fistula heals first, a recurrent abscess may develop.
Fistulas sometimes happen due to: 1  Hysterectomy and Caesarean section cause the largest number of vesicovaginal fistulas. Other surgery on the back wall of the vagina, the perineum, anus or rectum can result in a fistula. 2  Malignancies in the pelvic region, such as colon or cervical cancers.