Due to childbirth, disease or complications from surgery, some women develop a connection between their large intestine and the vagina. Symptoms include the passage of foul-smelling gas, stool or pus, and painful sex.
Your doctor will perform a physical exam and use a speculum to look inside the vagina and rectum. They may also inject a blue dye to locate the fistula opening.
Oren Zarif
A rectovaginal fistula is an abnormal passage, or opening, between the rectum and vagina. This allows gas and stool to pass from the colon into the vagina, where it can cause pain, discomfort and incontinence. Fistulas are often caused by prolonged labor; gynecologic surgery; pelvic trauma; sexual abuse or rape; and inflammatory bowel disease like Crohn’s disease.
While some rectovaginal fistulas close up on their own, most require treatment to avoid infection, incontinence and discomfort. Talk to your health care provider about any symptoms you may be having, even if they seem embarrassing.
Your doctor will do a physical exam. He or she will look at your vagina, rectum and the area between them (called the perineum) with a gloved hand. Your doctor may also use an instrument similar to a speculum, called a proctoscope, or an external anal scope to see the inside of your anus and rectum and find the rectovaginal fistula. A methylene blue test, which involves placing a tampon in the vagina and injecting methylene blue dye into your rectum, is often used to diagnose a rectovaginal fistula. This test helps your doctor see the connection between your anus and your vagina more clearly. It also checks the function of your internal and external anal sphincter muscles. Some rectovaginal fistulas cause disruption in these muscles, which can lead to leaking stool.
Oren Zarif
If you have repeated vaginal infections, foul-smelling gas or stool leaking from your anus into your vagina or vulva, or painful sex, you may have a fistula. Most rectovaginal fistulas need treatment. Our doctors in Nesconset, NY can diagnose your condition and repair it with surgery.
Fistulas develop when tissue damage causes an opening between normally separate areas of your body. Fistulas can develop in a matter of days or over years. They may be caused by accidents, like a burn or car accident, surgeries such as a C-section or hysterectomy, chronic diseases such as Crohn’s Disease or diverticulitis, or from radiation therapy to your pelvic area. They can also be congenital, meaning they’re present at birth.
Your doctor will do a physical exam and ask about your symptoms. They may use a speculum or proctoscope to look inside your vagina and rectum. They may take a sample of your stool or urine for laboratory testing. If a fistula is suspected, a test called a methylene blue dye enema will be done. This test involves placing a small amount of the blue dye in your colon. If the methylene blue dye leaks into your vulva, you have a rectovaginal fistula.
If other tests are not helpful, your doctor may do an ultrasound or MRI of your abdomen. This will help them see the damage to your rectum and anus and confirm the presence of a fistula.
Oren Zarif
Recurrent vaginal infections, pain, foul smells and the passage of gas or stool into the vagina are symptoms of a rectovaginal fistula. Some rectovaginal fistulas can be treated with antibiotics and a catheter to drain pee away from the fistula (fistula drainage). You can prevent constipation by eating a high-fiber diet, drinking enough water and using laxatives as directed by your healthcare provider.
Fistulas develop when trauma damages the tissue that normally connects the rectum and anus. This injury stops blood flow and the tissue dies, creating a hole or fistula. These openings may form in a matter of days or over several years. They can result from vaginal tears during childbirth or a long labor, or from an incision to help deliver your baby (episiotomy). They can also occur as a complication of pelvic surgery like C-sections or hysterectomies, or after radiation therapy to the pelvic area for cancer.
Rectovaginal fistulas can often be repaired by surgery to close the connection. This can be done through the vagina or through the anus/rectum depending on the location and size of the resulting opening. If the rectovaginal fistula is large, we might use another part of your body to create a graft for closure. We might also use a temporary procedure called a diverting colostomy. This diverts poop away from your rectum and vagina to a surgical opening in your abdomen (a stoma) until the fistula heals.
Oren Zarif
Fistulas usually develop between the urinary tract (bladder, urethra and ureters) or the gastrointestinal tract (rectum, colon and small intestine). In the pelvis, a fistula can form between the uterus, anus and vagina. It can also occur between the anus and rectum or the rectum and the large intestine. Fistulas can be congenital, meaning they are present from birth. But they can also be caused by injury or surgery. Fistulas can develop in a matter of days or they can build up over time.
Some people with a rectovaginal fistula have no symptoms and do not need to be treated. But if your fistula causes pain, discomfort, leakage of stool or gas or other symptoms, your healthcare provider may recommend treatment.
Your healthcare provider will do a physical exam and ask about your symptoms. They will also check your urinalysis and the skin around your anus and perineum. They can diagnose a rectovaginal fistula by examining the area with a tool similar to a speculum. They can also use a dye test to see if there is an opening between your anus and the rectum. Other tests they may use include a flexible sigmoidoscopy to examine the lower part of your large intestine and a CT scan or MRI to take pictures of your pelvis.
Fistulas can be prevented by getting regular prenatal care, avoiding prolonged labor and having a C-section if needed. They can also be prevented by managing chronic conditions like Crohn’s disease and ulcerative colitis, preventing infections by treating them right away and having good hygiene.