A rectovaginal fistula is an abnormal connection between the lower portion of your large intestine — your rectum — and your vagina. Contents of your bowel can leak through the fistula, meaning you might pass gas or stool through your vagina.
A rectovaginal fistula may result from an injury during childbirth, Crohn's disease or other inflammatory bowel disease, radiation treatment or cancer in the pelvic area, or a complication following surgery in the pelvic area.
The symptoms of a rectovaginal fistula often cause emotional distress as well as physical discomfort, which can impact self-esteem and intimate relationships. Though bringing up the subject with your doctor may be difficult, it's important to have a rectovaginal fistula evaluated. Some rectovaginal fistulas may close on their own, but most need to be repaired surgically.
Depending on the size and location of the fistula, you may have minor symptoms or significant problems with continence and hygiene. Signs and symptoms of a rectovaginal fistula may include:
When to see a doctor
A rectovaginal fistula may form as a result of:
Physical complications of rectovaginal fistula may include:
Among women with Crohn's disease who develop a fistula, the chance of another fistula forming later is high.
Preparing for your appointment
You're likely to start by seeing your primary care provider. However, in some cases when you call to set up an appointment you may be referred immediately to a doctor who specializes in conditions affecting the female reproductive tract (gynecologist).
What you can do
For rectovaginal fistula, some basic questions to ask your doctor include:
Don't hesitate to ask questions during your appointment anytime you don't understand something.
What to expect from your doctor
Tests and diagnosis
You can expect a physical exam and certain tests, explained below, depending on your needs.
Unless the fistula is very low in the vagina and readily visible, your doctor may use a speculum to see the inside of your vagina. An instrument similar to a speculum, called a proctoscope, may be inserted into your anus and rectum to check for problems. Your doctor may take a sample of tissue for lab analysis (biopsy) during the procedure.
Tests for identifying fistulas
Treatments and drugs
Symptoms of a rectovaginal fistula can be very distressing, but treatment generally offers good results. Treatment for the fistula depends on its cause, size, location and effect on surrounding tissues.
Surgery to close a fistula may be done by a gynecologic or colorectal surgeon. The goal is to remove the fistula tract and close the opening by sewing together healthy tissue. Surgical options include:
Lifestyle and home remedies
Good hygiene can help ease discomfort and reduce the chance of vaginal or urinary tract infections while waiting for repair.
For best results, be sure to follow any other recommendations from your health care team.
Last Updated: 2012-11-15
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