Rectovaginal Fistulas 2018-02-01T13:53:04+00:00


Rectovaginal Fistulas

Fistulas are abnormal connections between organs which can happen in almost anywhere; like between the rectum and vagina. Rectovaginal fistulas are abnormal connections between the vagina and rectum. It can only happen in women, not men. A fistula is a small tunnel. It is almost like a canal that connects one part of the body to the other.  Sometimes fistulas are a result of an abscess. In rectovaginal cases, they are a result of injury or some other intestine related disease. A fistula has more than just physical complications; it can also affect you emotionally. Rectovaginal fistulas have several symptoms which may include pain, irritation, or the passage of gas through the vaginal area. A fistula typically heals on its own. A lot of people do not like to wait for that, so surgery is an option for treatment.


Fistulas range in size and are located in different areas of the body. Some common places are between the skin and anus, artery and vein, or the rectum and anus, like what we are talking about here. Rectovaginal fistulas are divided into two groups. They are characterized based on their location. They are either high or low.  High rectovaginal fistulas are found more towards the middle of the rectum and end of the vagina. Low rectovaginal fistulas occur lower in the rectum and connect to the lower part of the vagina. The location of the fistula determines the treatment used. Fistulas can be as small as 0.5cm to 2.5cm in diameter.


Many different things cause rectovaginal fistulas. Childbirth is the most common cause of rectovaginal fistulas. If you are a man, you don’t have to worry about that. Most of the time during childbirth, the doctor makes a cut to enlarge the perineal area during childbirth. This area may get infected. If the cut is not large enough, you can also have a tear that creates a fistula. Different diseases make you susceptible to a rectovaginal fistula. Crohn’s disease and Inflammatory bowel disease are two diseases that affect the intestine. Just because you have an inflammatory bowel disease does not automatically qualify you for rectovaginal fistulas. It just puts you at a higher risk. The inflammation and irritation of the bowels tend to make channels into the vaginal area.

Surgery and cancer are other causes of rectovaginal fistulas. Surgery that involves the abdominal cavity typically puts you at risk for rectovaginal fistulas. Hysterectomies are one type of surgery. Vaginal, rectal, or anal surgeries also cause fistulas. Sometimes injuries happen during surgery that causes infection. Sometimes the surgeon can create a cut that creates leaks. Rectal, vaginal, cervical, and anal cancer all make you susceptible to fistulas. It is not necessarily cancer that is the problem; the main problem is radiation therapy as a form of treatment. Radiation damages the tissues in the rectal and vaginal cavity. The fistula may not happen instantly but after treatment is over. It could take a few years or a few months. In rare cases, ulcers and digestive issues may be the culprit.


Symptoms of rectovaginal fistulas include pain and irritation. Whatever is in the rectum may also pass through to the vagina. This means the vagina may have pus, stool, or gas flow through it. Emotionally, this can be embarrassing because you will have leakage of these things into your underwear. It also creates a very foul smell. Intercourse can also be very painful. The signs and symptoms of rectovaginal fistulas should be addressed right away. The main problem is that rectovaginal fistulas can create more serious symptoms. If you do not treat the problem right away, you may end up very sick.


Upon physical examination, the doctor can usually diagnose the problem. MRI and CT scans show a great visual image. Using dye may also help. The test is unconventional but helpful. The doctor inserts a tampon and then injects a blue dye into the rectum. If the dye stains the tampon, it means there is a fistula. Medication is usually the first form of treatment. A lot of times the fistula is infected, so antibiotics are necessary to get rid of bacteria. Other medication can help with inflammation due to Crohn’s disease or other inflammatory bowel diseases. Surgery is typically the best form of treatment. The doctor may sew the fistula or patch it with tissue. Sometimes it is necessary to repair the muscles damaged by the fistula. Your gynecologist can perform the surgery.


Rectovaginal fistulas cause a lot of symptoms but can be treated. If you are experiencing a rectal, vaginal fistula, make sure to see a physician right away. The rectovaginal fistula may cause infection and other pro blems. While you are healing, it is best to be up on your hygiene. Washing gently every time there is leakage through the vagina will help minimize the smell. It is good to make sure after washing you are completely dry. Certain creams help ease irritation and discomfort. Through proper care, you can prevent further damage from rectovaginal fistulas and ease your physical and emotional discomfort.


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