A rectovaginal fistula is a tunnel-like opening that develops between your vagina and rectum. Your vagina is a tube that connects your uterus to your vulva (genitals outside your body). Your rectum is the part of your digestive system that connects your large intestine (colon) to your anus. It holds stool and gas until your body releases them.
In a rectovaginal fistula, damage to vaginal tissue causes the tissue to tear or die and a hole (fistula) to form. This opening lets stool and gas enter your vagina. A rectovaginal fistula is a type of vaginal fistula.
Vaginal fistulas are holes that develop between your vagina or uterus (parts of the female reproductive system) and digestive system or urinary system organs.
In addition to the rectum, you may develop other digestive system fistulas, such as:
Colovaginal fistulas: Openings between your vagina and large intestine (colon).
Enterovaginal fistulas: Openings between your vagina and small intestine.
As many as 100,000 people worldwide develop vaginal fistulas every year.
These fistulas can occur after difficult vaginal labors. Pressure from your baby pushing against your vaginal wall can reduce blood flow, causing tissue death or tear the tissue.
Trauma to vaginal tissue or pressure to the tissue that stops blood flow, causing the tissue to die and creating a fistula are by far the most common causes. Rectovaginal fistulas can develop in a matter of days or they may form over several years. A person rarely has a congenital rectovaginal fistula, which means the opening is present at birth.
Symptoms of a rectovaginal fistula include:
The IWI team will perform a physical exam and pelvic exam. They’ll also ask about your symptoms.
Diagnostic tests for rectovaginal fistulas include:
Small rectovaginal fistulas may heal on their own over time. You may need antibiotics for infections or medications for IBD.
Most people with rectovaginal fistulas need surgery to close the opening. Dr Guerette may use your tissue or a collagen graft to repair a rectovaginal fistula. Success rates are over 90%. Diagram
These steps can aid your recovery after rectovaginal fistula repair surgery:
Most people who have rectovaginal fistula repair recover fully. They no longer have symptoms.
Rarely, a fistula doesn’t heal properly, or it opens up again after treatment. This is most likely to happen if you have colon cancer or Crohn’s disease or other risk factors like poorly controlled diabetes or if you smoke.
Appropriate care is critical. Living with symptoms of an untreated rectovaginal fistula can lead to infection, social isolation, depression or anxiety.
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