Review article| Volume 82, ISSUE 6, P1261-1272, December 2002

Rectovaginal fistula

  • Theodore J. Saclarides
    Rush-Presbyterian-Saint Luke's Medical Center, 1653 West Congress Parkway, Chicago, IL 60612
    Rush Medical College, Rush University, 600 South Paulina Street, Chicago, IL 60612, USA

    Rush-Presbyterian-Saint Luke's Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA
    Search for articles by this author
      Diseases of the anorectal region and genitalia may be accompanied by significant psychosocial and sexual dysfunction. This is especially so for women who suffer from rectovaginal fistulas whereby the vaginal passage of gas and stool can not only cause physical symptoms of inflammation and irritation but also impact adversely on self esteem, intimacy, and long-term relationships. The focus of this article is on fistulas between the rectum and the vagina; it does not deal with enterovaginal or colovaginal fistulas. For those, laparotomy is frequently required and there is little opportunity for local attempts at fistula repair. This concern, however, is offset by the relative surplus of healthy tissue available to work with produced by mobilization of proximal colon. Thus, generally good results and low recurrence rates can be anticipated. This is certainly not the case with rectovaginal fistulas, where conservative, local attempts at repair must frequently take into consideration the fact that the tissue used for repair may not be completely normal or in its maximum state of health.
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