Rectovaginal fistula

Rectovaginal fistula is a medical condition characterized by an abnormal connection (fistula) between the rectum and the vagina. This condition can result in fecal incontinence and can significantly impact the quality of life of the affected individual.

Etiology

Rectovaginal fistulas can be caused by a variety of factors. The most common causes include obstetric trauma, such as injury during childbirth, and Crohn's disease, a type of inflammatory bowel disease. Other causes can include radiation therapy, surgical complications, and cancer.

Symptoms

The primary symptom of a rectovaginal fistula is the uncontrollable passage of gas or stool from the vagina. Other symptoms can include recurrent urinary tract infections, foul-smelling vaginal discharge, and discomfort or pain in the vaginal or rectal area.

Diagnosis

Diagnosis of a rectovaginal fistula typically involves a physical examination, during which the doctor may be able to see or feel the fistula. Additional tests may include a barium enema, which can help visualize the fistula, and endoscopy, which allows the doctor to view the inside of the rectum and vagina.

Treatment

Treatment for rectovaginal fistulas depends on the cause and severity of the fistula. In some cases, the fistula may heal on its own with conservative management, such as dietary changes and medication. In other cases, surgery may be required to repair the fistula. Surgical options include fistulotomy, where the fistula is cut open and allowed to heal from the inside out, and flap advancement, where healthy tissue is moved to cover the fistula.

Prognosis

The prognosis for individuals with a rectovaginal fistula depends on the underlying cause and the success of treatment. With appropriate treatment, many individuals can achieve a good quality of life.

See also

• Fistula
• Obstetric fistula
• Vesicovaginal fistula