A rectovaginal fistula is a medical condition in which there is an abnormal connection between the rectum and the vagina, allowing stool or gas to pass from the rectum into the vagina. This condition can cause significant discomfort, embarrassment, and social isolation for women affected by it. In this article, we will discuss the causes, symptoms, diagnosis, and treatment options for rectovaginal fistula in women.
Causes
The most common cause of rectovaginal fistula in women is injury or trauma to the area during childbirth. The pressure and stretching of the tissues during delivery can cause tearing or damage to the rectum or vagina, which can lead to the formation of a fistula. Other potential causes of rectovaginal fistula include inflammatory bowel disease (such as Crohn's disease), radiation therapy, infections, and surgical complications.
Symptoms
The most common symptom of rectovaginal fistula is the passage of stool or gas through the vagina. Women may also experience vaginal discharge that smells like stool, as well as persistent discomfort, pain, or itching in the vaginal or anal area. Rectovaginal fistula can also cause recurrent urinary tract infections, as the bacteria from the stool can enter the urinary tract.
Diagnosis
To diagnose a rectovaginal fistula, a doctor will perform a physical examination, including a pelvic exam. They may also order additional tests, such as a colonoscopy or an MRI, to determine the location and extent of the fistula. In some cases, a dye may be injected into the rectum to help identify the exact location of the fistula.
Treatment
The treatment for rectovaginal fistula will depend on the underlying cause and the severity of the condition. In cases where the fistula is small and the symptoms are mild, conservative treatments such as dietary changes and medication may be recommended. For example, increasing fiber intake and taking stool softeners may help reduce the amount of stool passing through the fistula and improve symptoms.
In more severe cases, surgery may be necessary to repair the fistula and restore normal bowel function. The type of surgery performed will depend on the location and extent of the fistula. In some cases, a simple repair may be sufficient, while in others, a more complex procedure may be required. Surgery may involve removing damaged tissue, creating a new connection between the rectum and vagina, or using a tissue graft to close the fistula.
In cases where the fistula is caused by inflammatory bowel disease or radiation therapy, treatment may also involve addressing the underlying condition. This may include medication, dietary changes, or additional surgery to manage the underlying disease.
Complications
If left untreated, rectovaginal fistula can cause significant complications, including chronic pain, infection, and fecal incontinence (the inability to control bowel movements). It can also lead to significant psychological distress and social isolation due to the embarrassment and stigma associated with the condition.
Prevention
While it may not be possible to prevent all cases of rectovaginal fistula, there are steps women can take to reduce their risk. This includes maintaining a healthy weight, avoiding smoking, and practicing good hygiene in the genital area. Women who are planning to become pregnant may also benefit from working with their healthcare provider to develop a birth plan that reduces the risk of injury or trauma during childbirth.
In conclusion, rectovaginal fistula is a challenging medical condition that can cause significant
Dr Sambit Patnaik is a minimal invasive, laser and robotic colorectal surgeon trained in India and abroad who runs Mumbai Piles Laser Clinic located at Chembur , Kurla, Tardeo and Charni Road for laser treatment of piles hemorrhoids anal fissure and anal fistula. Dr Sambit Patnaik practises in Dubai and Mumbai. He is also attached to many premier hospitals in Mumbai