Rectovaginal Fistula: Causes & Treatment | Dr. Ashok Kumar

Rectovaginal Fistula Repair Surgery

Specialized Reconstruction by Dr. Ashok Kumar

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What is Rectovaginal Fistula?

Rectovaginal fistula is abnormal tract between rectum and vagina. Causes stool in vagina, recurrent infections, and severe psychological distress. Rare but requires specialized surgical expertise. Dr. Ashok Kumar specializes in complex fistula reconstruction.

Causes & Symptoms

  • Obstetric trauma (most common)
  • Inflammatory bowel disease (Crohn's)
  • Radiation therapy
  • Colorectal surgery
  • Symptoms: Stool/gas in vagina, fecal incontinence, vaginal discharge

Surgical Reconstruction

Endorectal Flap Advancement

Most common approach. Mobilizes rectal mucosa and advances to cover internal opening. Preserves sphincter function. Success rates 60-80% depending on etiology and complexity.

Transanal Repair

For simple, lower fistulas. Limited local repair techniques. Dr. Ashok Kumar selects approach based on individual fistula anatomy.

Recovery & Outcomes

Hospital stay 2-4 days. Healing 8-12 weeks. Return to normal activities 6-8 weeks. Success varies by technique and etiology. Staged procedures sometimes needed for complex fistulas. Excellent functional preservation with proper technique.

Related Conditions

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Phone: 05226664444

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Dr. Ashok Kumar

Surgical Gastroenterologist

  • MCh - SGPGI
  • FRCS
  • FACS
  • FASCRS
Profile

What is a rectovaginal fistula?

A rectovaginal fistula is an abnormal connection between the rectum and the vagina. Because of this opening, gas, stool or mucus can pass into the vagina. It is a distressing condition, but it can be treated, and many women regain normal function after repair.

Causes

  • Injury during childbirth, especially after prolonged or difficult labour or a severe tear
  • Crohn's disease and other inflammatory bowel diseases
  • Complications of pelvic, rectal or vaginal surgery
  • Radiation treatment for pelvic cancers
  • Infection or abscess in the area
  • Cancer of the rectum, cervix or vagina (less common)

Symptoms

  • Passage of gas or stool through the vagina
  • Foul-smelling vaginal discharge
  • Repeated vaginal or urinary infections
  • Pain during intercourse
  • Irritation of the skin around the vagina

Diagnosis

A gynaecological and rectal examination often shows the opening. When it is small or high, tests such as MRI, endoanal ultrasound, a dye test or examination under anaesthesia help locate it. Your doctor may also look for an underlying cause such as Crohn's disease and check whether the sphincter muscles are intact.

Treatment

A small number of fistulas caused by recent injury or infection may close once the inflammation settles, so surgery is sometimes delayed for a few months while the tissues heal. Most fistulas need an operation.

  • Local repair through the rectum or vagina, such as an advancement flap
  • Repair combined with sphincteroplasty when the sphincter muscle has also been injured
  • Tissue interposition, in which healthy tissue is placed between the rectum and vagina for complex or recurrent fistulas
  • A temporary stoma in some complex cases to protect the repair while it heals
  • Treatment of the underlying cause, such as Crohn's disease

Recovery

Recovery depends on the type of repair. You will be advised to keep stools soft, avoid heavy lifting and avoid intercourse until your surgeon confirms healing, usually after several weeks.

Frequently asked questions

Can a rectovaginal fistula heal without surgery?

Occasionally a small fistula from a recent injury heals once infection and inflammation settle, but most need surgical repair.

Will I need a stoma?

Most repairs do not need a stoma. A temporary stoma may be advised for complex, recurrent or radiation-related fistulas.

Can I have children after repair?

Many women can. Your surgeon and gynaecologist will advise on the safest mode of delivery to protect the repair.

Related pages

Book a consultation: call 0522-666-4444 or use the request call back form on this page. In an emergency, come straight to the 24/7 emergency department at Charak Hospital, Hardoi Road, Dubagga, Lucknow.