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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© 2002 Elsevier Science (USA). Published by Elsevier Inc. All rights reserved.
