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Rectovaginal Fistula

About the Disease

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. 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.

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.

A fistula may be the first warning of a more serious problem, such as an infected, pus-filled area (abscess) or cancer.

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.

    Dr. Rama Joshi

    Dr. Rama Joshi

    Director

    Fortis Memorial Research Institute, Gurgaon

    Dr. Hrishikesh D Pai

    Dr. Hrishikesh D Pai

    Senior Consultant & Head

    Fortis Memorial Research Institute, Gurgaon

    Dr. Monika  Chaudhary

    Dr. Monika Chaudhary

    Consultant - Gynaecology

    Paras Hospital, Gurgaon

    Dr. Sabhyata Gupta

    Dr. Sabhyata Gupta

    Director

    Medanta The Medicity, Gurgaon

    Dr. Nupur Gupta

    Dr. Nupur Gupta

    Consultant and Unit Head, Obstetrics and Gynaecology

    Paras Hospital, Gurgaon

    Dr. Pooja  Mehta

    Dr. Pooja Mehta

    Consultant, Obstetrics & Gynaecology

    Paras Hospital, Gurgaon

    Dr. Amit Kumar Patil

    Dr. Amit Kumar Patil

    Consultant - Gynaecology & Laproscopic Surgery and IVF

    Aditya Birla Memorial Hospital, Pune

    Dr. Vivek Marwah

    Dr. Vivek Marwah

    Senior Consultant & Head

    Max Super Speciality Hospital, Saket, New Delhi

    Dr. Swasti .

    Dr. Swasti .

    Consultant - Gynae Oncology

    Max Super Speciality Hospital (Pushpanjali Crosslay), Vaishali, Ghaziabad

    Dr. Kanika Gupta

    Dr. Kanika Gupta

    Director & Senior Consultant - Gynae Oncology

    Max Super Speciality Hospital (Pushpanjali Crosslay), Vaishali, Ghaziabad

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