Rectovaginal fistula
A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina. [1]
Rectovaginal fistula may be extremely debilitating. If the opening between the rectum and vagina is wide it will allow both flatulence and feces to escape through the vagina, leading to fecal incontinence. There is an association with recurrent urinary and vaginal infections. This type of fistula can cause pediatricians to misdiagnose imperforate anus.
Causes
Rectovaginal fistulae are often the result of trauma during childbirth (in which case it is known as obstetric fistula) in situations where there is inadequate health care, such as in some developing countries. Rates in Eritrea are estimated as high as 350 per 100,000 vaginal births. Fistulas can also develop in women and children who are raped; women with rectovaginal fistulae are often stigmatized in third world countries, and become outcasts.[2] It is also associated with female genital mutilation.
Rectovaginal fistulae can also be a symptom of various diseases, including infection by Lymphogranuloma venereum,[3] or the unintended result of surgery, such as episiotomy or sexual reassignment surgery. They may present as a complication of vaginal surgery, including vaginal hysterectomy. They are a recognized presentation of rectal carcinoma or rarely diverticular disease of the bowel or Crohn's disease. They are seen rarely after radiotherapy treatment for cervical cancer.
See also
References
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