A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina. Passage of gas, stool or pus from the vagina. Foul-smelling vaginal discharge. Recurrent vaginal or urinary tract infections. Irritation or pain in the vulva, vagina and the area between the vagina and anus (perineum) Pain during sexual intercourse.
After diagnosing rectovaginal fistula, it is best to wait for around 3 months to allow the inflammation to subside. For low fistulae, a vaginal approach is best, while an abdominal repair would be necessary for a high fistula at the posterior fornix. A circular incision is made around the fistula and vagina is separated from the underlying rectum with a sharp circumferential dissection. The entire fistulous tract, along with a small rim of rectal mucosa is incised. The rectal wall is then closed extramucosally.
The results of second surgery 12/12 patients (100%) after sphincteroplasty healed versus 11/15 (73%) patients treated with either layered closure or advancement flap, but this did not reach statistical significance.