DefinitionRectovaginal fistula is an abnormal connection between the rectum and the vagina. Gas or stool may leak from the bowel into the vagina.
|Healthy Wall Between Vagina and Rectum|
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CausesA rectovaginal fistula is caused by an injury to this area. It may be caused by physical trauma or a medical condition.
Risk FactorsFactors that may increase your risk of rectovaginal fistula include:
- Crohn’s disease
- Complications following surgery to the perineum (area between vagina and rectum), vagina, rectum, or anus
- Injuries during childbirth
- Radiation treatment or cancer in the pelvic area
- Perianal infection
SymptomsSymptoms may include:
- Passing stool or gas via the vagina
- Inability to control bowel movements
- Foul-smelling vaginal discharge
- Pain during sexual intercourse
- Persistent pain in the pelvic area
DiagnosisYou will be asked about your symptoms and medical history. A physical exam will be done. You may need to see a colon and rectal surgeon.Your body structures may need to be viewed. This can be done with:
- Anorectal ultrasound—a small wand-like instrument provides a video image of the rectum and anus
- Methylene enema—a tampon is placed in the vagina and methylene blue is placed into the rectum to identify movement of fluid from rectum to vagina
- Contrast studies— barium enema may be used to view a rectovaginal fistula that cannot be seen on physical exam
- Endoscopy—a thin, lighted tube is inserted into the rectum to examine the rectum and the lower colon (to rule out irritable bowel disease)
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