Rectovaginal fistula

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.

Symptoms Causes Complications

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:

  • Passage of gas, stool or pus from your vagina
  • A foul-smelling vaginal discharge
  • Recurrent vaginal or urinary tract infections
  • Irritation or pain in the vulva, vagina and the area between your vagina and anus (perineum)
  • Pain during sexual intercourse

When to see a doctor

If you experience any signs or symptoms of rectovaginal fistula, make an appointment to see your doctor. A fistula may be the first indication of a more serious problem, such as an area of infection where pus has collected (abscess) or cancer. It's important that your doctor identify the cause of the fistula and determine whether and when it should be repaired. Depending on the cause, your doctor may refer you to a colorectal or gynecologic surgeon.

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