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Check for pain around the anus or genitals. Look for unusual bleeding or discharge. Make note of urinary problems. Watch for gastrointestinal symptoms. Note any general symptoms of illness.

Article:
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).  Anal fistulas may cause pain during bowel movements.  Fistulas involving the vagina may cause pain during sexual intercourse. Fistulas may cause bleeding or discharge around the anus or genitals. You may notice that the discharge is foul-smelling, or that it contains pus. If you have a vaginal fistula, you may have vaginal discharge that contains pus or feces. You might also notice gas leakage from your vagina. Fistulas involving the bladder can cause a variety of urinary tract symptoms. In addition to frequent urinary tract infections, you may experience:  Difficulty holding your urine, or leakage of urine from unusual places (e.g., your vagina). The passage of gas from your urethra (the opening between your bladder and your genitals) when you pee. Discolored, cloudy, or bad-smelling urine. Fistulas can cause pain in the pelvis or abdomen. You might also notice nausea, diarrhea, or vomiting. While these can be symptoms of many different conditions, they may indicate a fistula if you experience them in combination with other common fistula symptoms (such as genital pain and discharge). In addition to more specific symptoms, fistulas can cause vague symptoms that affect your whole body. These symptoms may indicate an infection associated with the fistula. You might notice symptoms such as:  Fever. Chills. Fatigue. A general feeling of being ill.