Recto Vaginal Fistulas

A rectovaginal fistula is an abnormal connection (fistula) between the rectum and the vagina. This condition can result in a range of symptoms and complications, and it typically requires medical evaluation and treatment.

Symptoms of Recto Vaginal Fistulas

1. Vaginal Discharge may be malodorous due to the presence of fecal material or bacteria.
2. The introduction of bacteria from the rectum can lead to frequent infections in the vaginal area.
3. Some individuals may experience pain in the vaginal or rectal area.
4. Excess mucus in the stool.

Types of Recto Vaginal Fistulas

1. Childbirth, particularly when there is significant tearing or complications during delivery, can lead to the development of a fistula.
2. Previous surgeries in the pelvic area, such as hysterectomy or rectal surgery, can increase the risk of fistula formation.
3. Conditions such as Crohn's disease can lead to inflammation and ulcers in the rectum and vagina, increasing the risk of fistula formation.
4. Pelvic radiation therapy, particularly for cancer treatment, can damage tissues and increase the risk of fistula formation.
5. Severe infections in the rectal or vaginal area can lead to the development of a fistula.

Treatment

1. Small fistulas may be managed conservatively with dietary changes and medications.
2. Surgery is often required to close the fistula. Various techniques, such as direct repair, tissue grafting, or a more complex approach, may be used depending on the specific case.
3. If the fistula is caused by an underlying condition such as Crohn's disease, treatment of the condition is essential to prevent recurrence.
4. In some severe cases, a temporary or permanent colostomy may be needed to divert stool away from the fistula to allow healing.

Diagnosis

A rectovaginal fistula is typically diagnosed through:
1. The healthcare provider will take a detailed history of symptoms and risk factors.
2. A pelvic examination can help identify the presence of a fistula.
3. Tests such as a pelvic MRI, CT scan, or fistulography (a special X-ray) can help confirm the diagnosis and determine the size and location of the fistula.