Version May 2024
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What is a rectovaginal fistula? — A rectovaginal fistula is an abnormal connection between the lower part of the large intestine (rectum) and the vagina (figure 1). Different things can cause rectovaginal fistula, including:
●Injury during labor and childbirth – This is the most common cause.
●Damage from radiation used to treat cancer
●Crohn disease (a disorder that can cause diarrhea, belly pain, and other digestive problems)
What are the symptoms of a rectovaginal fistula? — The symptoms can include:
●Gas or bowel movements passing out of the vagina
●Bad smell coming from the vagina
●Pain or irritation in or near the vagina
Are there tests for a rectovaginal fistula? — Yes. Your doctor or nurse might be able to tell if you have it by learning about your symptoms and doing an exam. For the exam, the doctor will put gloved fingers inside your vagina and your anus at the same time.
But you might need tests that include:
●Blue dye test – For this test, the doctor or nurse uses a blunt needle to put a blue dye into your rectum. Then, they check for blue dye in your vagina.
●Proctoscopy – For this test, the doctor puts a narrow tube with a light at the end into your rectum to check the area.
●Imaging tests, such as an MRI or a CT scan – These tests create pictures of the inside of the body.
How is a rectovaginal fistula treated? — Small fistulas that do not cause serious symptoms might not need treatment. More serious rectovaginal fistulas are treated with an operation to close and repair the fistula.
After surgery, you should:
●Drink only fluids for several days.
●Eat foods that will help you have fewer and smaller bowel movements. Your doctor or nurse will tell you more about this diet and how long you need to stay on it.
●Take "sitz" baths – This is a shallow, warm bath that helps clean and heal the vaginal area. Take them twice a day for 30 minutes each for 2 to 3 days.
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