• Dr.Bhavik Rana(Consultant)|Vapi & Valsad

  • +91-97242 47109

Disease

Rectoveginal Fistul

A rectovaginal fistula is an abnormal connection between the lower portion of your large intestine — your rectum — and your vagina. Bowel contents can leak through the fistula, allowing gas or stool to pass through your vagina..


A rectovaginal fistula may result from:

  • Injury during childbirth
  • Crohn's disease or other inflammatory bowel disease
  • Radiation treatment or cancer in the pelvic area
  • Complication following surgery in the pelvic area

The condition may cause emotional distress and physical discomfort, which can impact self-esteem and intimacy.

Talk with your doctor if you have signs and symptoms of a rectovaginal fistula, even if it's embarrassing. Some rectovaginal fistulas may close on their own, but most need surgical repair.

Symptoms

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Depending on the fistula's size and location, you may have minor symptoms or significant problems with continence and hygiene. Signs and symptoms of a rectovaginal fistula may include:


  • Passage of gas, stool or pus from your vagina
  • Foul-smelling vaginal discharge
  • Recurrent vaginal or urinary tract infections
  • Irritation or pain in the vulva, vagina and the area between your vagina and anus (perineum)
  • Pain during sexual intercourse

Causes

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A rectovaginal fistula may form as a result of:

  • Injuries during childbirth. Delivery-related injuries are the most common cause of rectovaginal fistulas. This includes tears in the perineum that extend to the bowel, or an infection of an episiotomy — a surgical incision to enlarge the perineum during vaginal delivery. These may happen following a long, difficult, or obstructed labor. These types of fistulas may also involve injury to your anal sphincter, the rings of muscle at the end of the rectum that help you hold in stool.
  • Crohn's disease. The second most common cause of rectovaginal fistulas, Crohn's disease is an inflammatory bowel disease in which the digestive tract lining is inflamed. Most women with Crohn's disease never develop a rectovaginal fistula, but having Crohn's disease does increase your risk of the condition.
  • Cancer or radiation treatment in your pelvic area. A cancerous tumor in your rectum, cervix, vagina, uterus or anal canal can result in a rectovaginal fistula. Radiation therapy for cancers in these areas can also put you at risk. A fistula caused by radiation usually forms within six months to two years after treatment.
  • Surgery involving your vagina, perineum, rectum or anus. Prior surgery in your lower pelvic region, such as removal of your uterus (hysterectomy), in rare cases can lead to development of a fistula. The fistula may develop as a result of an injury during surgery or a leak or infection that develops afterward.
  • Other causes. Rarely, a rectovaginal fistula may be caused by infections in your anus or rectum; infections of small, bulging pouches in your digestive tract (diverticulitis); long-term inflammation of your colon and rectum (ulcerative colitis); dry, hard stool that gets stuck in the rectum (fecal impaction); or vaginal injury unrelated to childbirth.


Complications

Physical complications of a rectovaginal fistula may include:


  • Uncontrolled loss of stool (fecal incontinence)
  • Hygiene problems
  • Recurrent vaginal or urinary tract infections
  • Irritation or inflammation of your vagina, perineum or the skin around your anus
  • An infected fistula that forms an abscess, a problem that can become life-threatening if not treated

Fistula recurrence

Among women with Crohn's disease who develop a fistula, the chances of complications are high. These can include poor healing, or another fistula forming later.