Rectovaginal Fistula: Symptoms, Causes, and Treatment

A rectovaginal fistula is an abnormal connection between the rectum and vagina, causing stool or gas to pass through the vagina. This condition can lead to embarrassment, hygiene issues, and discomfort. It affects approximately 1 in 50,000 women. Seeking medical help is crucial for diagnosis and treatment options such as surgery to repair the fistula. It's essential to address this condition promptly to improve quality of life and prevent complications. Don't hesitate to consult a healthcare provider if you suspect you have a rectovaginal fistula.

Causes of Rectovaginal Fistula

Rectovaginal fistula can develop due to various factors. Some common contributors include:

• Obstetric trauma during childbirth
• Pelvic surgery complications
• Inflammatory bowel disease
• Radiation therapy
• Infections

Symptoms of Rectovaginal Fistula

Recognizing the symptoms of a rectovaginal fistula is crucial as early detection can significantly improve outcomes. Symptoms of a rectovaginal fistula may include:

• Unintentional passage of gas or stool through the vagina
• Recurrent vaginal or urinary tract infections
• Foul-smelling vaginal discharge
• Pain during intercourse
• Chronic diarrhea

Early identification of these symptoms can lead to prompt diagnosis and appropriate management, potentially preventing complications and improving the overall prognosis for individuals affected by a rectovaginal fistula.

Diagnosis of Rectovaginal Fistula

Diagnosing a rectovaginal fistula is crucial for effective treatment. Symptoms like fecal matter in the vagina, recurrent vaginal infections, and gas or stool leakage aid in diagnosis. Various methods help confirm the condition, including:

• Physical examination
• Endoanal ultrasound
• Magnetic resonance imaging (MRI)
• Fistulography

Accurate diagnosis is vital to determine the size, location, and cause of the fistula, guiding appropriate treatment decisions and improving patient outcomes.

Treatment Options for Rectovaginal Fistula

When it comes to treating rectovaginal fistula, personalized care is crucial as each case can vary in severity and underlying causes.

Surgical Repair

• This treatment involves surgical correction of the fistula, usually by suturing the opening between the rectum and vagina.
• It is the mainstay treatment to close the abnormal connection and restore normal bowel and vaginal function.
• The primary objective is to close the fistula and prevent fecal material from passing into the vagina.
• The procedure may involve identifying the fistula tract, excising the abnormal tissue, and then suturing the rectal and vaginal walls separately.

Fecal Diversion

• Involves redirecting fecal flow away from the affected area by creating a temporary colostomy or ileostomy.
• This approach allows the fistula to heal without the constant passage of stool, reducing infection risk and promoting healing.
• The primary objective is to give the fistula time to close and heal without the continuous passage of stool.
• The patient may undergo a colostomy or ileostomy procedure, followed by a subsequent surgery to reverse the diversion once the fistula has healed.

Prevention and Management of Rectovaginal Fistula

When it comes to preventing or managing rectovaginal fistula, lifestyle changes and proactive measures play a crucial role. Here are some key strategies to consider:

Lifestyle Modifications:

• Eat a high-fiber diet to prevent constipation, which can strain the pelvic floor muscles.
• Maintain a healthy weight to reduce pressure on the pelvic area.
• Avoid heavy lifting and activities that strain the pelvic floor.

Regular Screenings:

• Attend regular gynecological check-ups to detect any issues early on.
• Discuss any concerns or symptoms with your healthcare provider promptly.
• Follow up on any previous pelvic surgeries to monitor for potential complications.

Supportive Care:

• Seek emotional support from counselors or support groups to cope with the challenges.
• Follow your healthcare provider's recommendations for treatment and follow-up care.
• Engage in pelvic floor exercises to strengthen the muscles and support healing.

If you’ve been having any symptoms or worries about rectovaginal fistula, please reach out to our doctors. They will listen to your concerns, answer your questions and guide you through the next steps.