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Rectovaginal fistulas: Diagnosis and treatment methods

  • Ali Uzunköy

Turk J Colorectal Dis 2009;19(1):1-7

Rectovaginal fistula is defined as an epithelial communication between the rectum and vagina. Trauma, inflammatory bowel disease, infections, carcinoma, and irradiation consist of the major etiologic factors of rectovaginal fistulas. Rarely, they may be congenital. Obstetric trauma is an important etiological factor in development of rectovaginal fistulas. The main clinical symptoms of rectovaginal fistulas include vaginal passage of gas or stool. Endoscopy, methylene blue enema, endorectal or transvaginal ultrasound, and contrast studies may require for diagnosis. In case of suspicious malignancy, histopathological examination should be performed. Rectovaginal fistulas are classified as simple and complex fistulas. The main therapeutical option in rectovaginal fistulas is surgical procedure. Most rectovaginal fistulas can be successfully repaired by different surgical techniques. Repeated surgical interventions may be needed in recurrent rectovaginal fistulas. Surgical repair with well-vascularised tissue is an important surgical technique in prevention of recurrence.

Keywords: Rectovaginal fistula, inflammatory bowel disease, obstetric trauma