Rectovaginal fistula is an abnormal connection between the rectum and the vagina. Gas or stool may leak from the bowel into the vagina.
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This problem is caused by an injury to this area. The injury may be caused by trauma or a health problem.
Things that may raise the risk of this problem are:
- Crohn disease
- Recent surgery to the perineum (area between vagina and rectum), vagina, rectum, or anus
- Injuries during childbirth
- Radiation treatment or cancer in the pelvic area
- Infection in the area around the anus
Problems may be:
- Pain in the pelvic area
- Pain during sex
- Passing stool (poop) or gas through the vagina
- Problems controlling stool
- Foul-smelling vaginal discharge
The doctor will ask about symptoms and health history. A physical exam will be done.
Pictures of the area may need to be taken. This can be done with:
- Anorectal ultrasound—a small wand is used to make a video of the rectum and anus
- Methylene enema—a tampon is placed in the vagina and dye is placed into the rectum to watch how fluid moves from the rectum to the vagina
- Contrast studies— barium enema may be used to view a fistula that cannot be seen during an exam
- Endoscopy—a thin, lighted tube is placed in the rectum to view the rectum and the lower colon
Surgery will be done to close the opening between the rectum and vagina. Tissue may be taken from another part of the body as a graft. This tissue will help to close the fistula.
There are no known guidelines to prevent this health problem.
- Anorectal malformations. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/anorectal-malformations.
- Rectovaginal fistula repair. Atlas of Pelvic Surgery website. Available at: http://www.atlasofpelvicsurgery.com/2VaginalandUrethra/14RectovaginalFistulaRepair/chap2sec14.html.
- Elizabeth Margaret Prusak, MD
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