Talk with your doctor if you have signs and symptoms of a rectovaginal fistula, even if it's embarrassing. Some rectovaginal fistulas may close on their own, but most need surgical repair.
Depending on the fistula's size and location, you may have minor symptoms or significant problems with continence and hygiene. Signs and symptoms of a rectovaginal fistula may include:.
See your doctor if you experience any signs or symptoms of a rectovaginal fistula. A fistula may be the first warning of a more serious problem, such as an infected, pus-filled area abscess or cancer. Identifying the cause of the fistula can help your doctor determine a treatment plan. Among women with Crohn's disease who develop a fistula, the chances of complications are high. These can include poor healing, or another fistula forming later.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview A rectovaginal fistula is an abnormal connection between the lower portion of your large intestine — your rectum — and your vagina.
A rectovaginal fistula may result from:. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references deBeche-Adams TH, et al. Rectovaginal fistulas. Clinics in Colon and Rectal Surgery. Champagne BJ, et al. Rectovaginal fistula. The Surgical Clinics of North America. Tintinalli JE, et al. Anorectal disorders. Some people are never able to come off it.
Leakage from a fistula can be a distressing experience. The same enzymes in your gut that will digest a juicy steak will make contact with your skin and cause it to become excoriated , which means very red and sore with the skin breaking down just like that piece of meat. It is very painful and prone to infection which makes a bad situation worse.
Therefore fistula care by the ward nursing staff, led by a specialist stoma nurse, is vital in preventing these problems. Medication may also be used to reduce the output and acidity from the fistula. You will see a stoma nurse when in hospital and a plan of care will be put in place for the ward nursing staff to follow. Once discharged you will have access to a stoma nurse if any problems arise. They will occasionally do home visits if necessary or you can go to the hospital.
The ongoing management of a fistula depends on so many factors. Some people will have their fistulae repaired by undergoing more surgery. Unless faced with an emergency situation, there is usually a wait of at least 12 months before this can be attempted.
Some people will have to continue to receive nutritional support at home Home Parental Nutrition or HPN through their central vein as the damage to the gut is too great and normal nourishment would mean essential nutrients would be lost resulting in malnourishment.
In other words the food and waste would come out of the fistula before giving the bowel the chance to do its job — absorb all the nutrients and fluid from what we eat and drink. It depends of course on where in the bowel the fistula is.
HPN tends to happen more with a fistula that is high up in the bowel, this usually means the fistula output is high as much as several litres per day.
Most goes out through the ileostomy which is great news but some comes out of the fistula and whilst this connection remains it will never heal spontaneously.
If the cause of the fistula is found to be inflammatory bowel disease then sometimes medication can be given which will heal the gut and maybe the fistula. It is likely you will have to remain on these drugs for some time to control the underlying disease which may in turn keep the fistula closed. Sometimes no definite cause can be found for the fistula and the patient may not be suitable for surgical repair.
In these cases the patient will have to manage the fistula. This can prove to be very challenging, as it is likely the patient will need to wear a stoma bag over the fistula along with dealing with the daily problems a fistula can bring. A fistula is essentially a tube which our brilliant bodies make to keep us alive.
Fistulae are described as a surgical catastrophe. They are most certainly a very difficult complication which can be extremely challenging for the medical profession to deal with. However, the main challenges will have to be met by the patient — in my case, I have found it to be life changing. To go in for an operation in reasonable health and come out with a fistula is devastating. I had had a stoma bag for some 33 years previous to this and had managed it well, working full time and leading a normal life.
I never even needed a stoma nurse. This however was so different and way more difficult and three years later it continues to be a big factor it my life.
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