What is a Rectovaginal Fistula?

A rectovaginal fistula (RVF) is an abnormal connection between the rectum and the vagina. It allows stool and gas to pass through the vagina, causing significant distress, recurrent infections and profound impact on quality of life. Dr. Ashok Kumar has specific expertise in this condition, listed as a special interest on his personal website.

Causes

• Obstetric injury — third/fourth degree perineal tear during difficult childbirth (most common cause)
• Crohn's disease — perianal fistulising disease extending to vagina
• Previous anorectal surgery — haemorrhoidectomy, fistula repair
• Pelvic radiotherapy — for cervical, uterine or rectal cancer
• Pelvic trauma or foreign body

Symptoms

• Passage of stool, gas or faecal matter through the vagina
• Recurrent vaginal and urinary tract infections
• Foul-smelling vaginal discharge
• Pain during intercourse (dyspareunia)
• Faecal incontinence (if associated sphincter injury)