A bladder fistula is an abnormal tunnel between the bladder and another organ (bowel, vagina, or skin). Urine takes the side exit, so leaks and infections are the daily norm.

The star sign is extra leakage. You finish voiding, then notice a steady drip from the vagina, rectum, or a small hole on the lower belly.

Urine in the vagina or stool in the urine is a dead giveaway. Panty-liners smell like ammonia, or gas bubbles come out when you pee.

Recurrent urine infections loop back. Burning, urgency, and cloudiness return days after each antibiotic course.

Skin around the opening gets red, raw, and smells like stale urine, even with good hygiene.

Pain is usually mild but spikes during sex or when the fistula is pressed.

If bowel contents pass through the urethra, fecal odor or solid debris in the urine is an emergency alarm.