When an abnormal connection develops between the rectum and the vagina of a woman, it is termed a rectovaginal fistula. While rectovaginal fistula is not a life-threatening condition, it causes discomfort to the patient.
About rectovaginal fistula
If the rectum gets accidentally connected with the vagina, this medical condition is called a rectovaginal fistula. In this case, gas and stool may pass from the rectum to the vagina and come out abnormally from the vaginal opening. It is stressful for the patient and may cause emotional upheaval . Sometimes, the fistula may close without treatment. However, you may need surgery if it does not .
What are the symptoms of rectovaginal fistula?
- Emission of gas or stool from the vaginal opening
- Foul smell emitting from the normal vaginal discharge
- Frequent repetition of infections in the vaginal or urinary tract
- Feeling of immense pain during sexual intercourse
- Abnormal pain persisting in the vagina and the space between the vagina and anus
What are the causes of rectovaginal fistula?
Childbirth related injuries are the most common cause of rectovaginal fistulas. This includes tears in the perineum or due to an episiotomy — a surgical incision to enlarge the perineum during vaginal delivery. It may also be precipitated by a long, difficult, or obstructed labor.
Inflammation in the bowel caused by ulcerative colitis or Crohn’s disease can lead to the formation of the rectovaginal fistula.
Surgery in the organs of the pelvic region, such as the rectum, anus, perineum, or vagina can result in an infection or injury, leading to this fistula.
The application of radiation for the cure of cancer in the uterus, vagina, rectum, or anus can form the fistula as a side effect.
When to see a doctor?
If you see any of the above-said symptoms, you need to contact a gynecologist They can provide a treatment plan for curing the rectovaginal fistula and save you from discomfort.
Effective treatment for curing rectovaginal fistula
- Your doctor may do a clinical examination to find the existence of a fistula in your rectovaginal area. Vaginogram or barium enema, blue dye test, CT scan of the abdomen and pelvis , MRI of the pelvis , anorectal ultrasound and manometry are also useful in detecting the rectovaginal fistula . Colonoscopy and biopsy are recommend to confirm other bowel-related diseases, other than this fistula.
- Following confirmation of diagnosis, surgical procedures can be done to repair the fistula , depending on your health condition. Before surgery , the skin including other tissue around the fistula should be healthy, with no inflammation or infection. Your doctor may advise waiting 3 to 6 months to ensure this and also to allow the fistula to close on its own. Antibiotic medicines can also be given before the surgery if the area around the fistula is infected, you may be put on an antibiotic course before surgery. Infliximab can decrease the inflammation of the fistula, leading to faster healing in women suffering from Crohn’s disease.
Surgical options include:
- Sewing an anal fistula plug or patch of biologic tissue into the fistula to allow the tissue to grow into a patch and heal fistula.
- Using a tissue graft taken from your body’s nearby part or folding a flap of healthy tissue over the fistula opening.
- Repairing the anal sphincter muscles
- Sometimes a colostomy is needed before repairing a fistula to divert stool through an opening in the abdomen instead of through the rectum. Most of the time, this surgery is not needed.
You can easily recover from a rectovaginal fistula. An experienced gynecologist can help you to be cured of this medical condition and save you from an embarrassing situation. You should not hesitate in discussing the symptoms of fistula with your doctor.
Frequently Asked Questions (FAQs)
How to deal with the problem of rectovaginal fistula without or before the surgery?
You should clean your vagina regularly with lukewarm water and a mild soap every time stool passes through it. You should dry this space carefully. You should wear loose cotton undergarments to make yourself comfortable. Avoid sented or harsh soap including scented tampons and pads. Vaginal douches may increase the chance of the infection.
What are the probable complications caused by the fistula in the rectovaginal space?
- Uncontrolled passage of stools
- Inflammation or irritation of your vagina, perineum or the skin around the anus
- Recurrent urinary tract or vaginal infections
- Fistula recurrence
- An infected fistula that forms an abscess
- Being affected emotionally
Is there any risk with the surgery for curing the rectal fistula?
Like all surgeries, the surgery done for curing rectovaginal fistula may be accompanied by unexpected bleeding and post-surgical infections. However, surgeons take care to keep their patients safe from all risks during or after the surgeries.