Vaginal rectal fistula: Causes, complications

Rectal-vaginal fistula is not a very common disease, but it greatly affects the quality of life and health of patients.

Recto-Vaginal fistules recto-vaginales is a rare phenomenon with an incidence of only about 5% in purulent anal infections.
Rectal-vaginal fistula is an abnormal connection between the two mucosal tubes of the rectum and vagina. Substances in the intestines can leak through the fistula, allowing gas or stool to pass through the vagina. There are 2 types of rectal fistula: simple fistula (lower fistula, small size, less than 2.5cm) and complex fistula (high fistula, large fistula size, over 2.5cm). The large and small size of the fistula can affect the severity and mildness of the disease symptoms.
Symptoms of rectal-vaginal fistula depend on the location, size and cause of the fistula. Specifically, patients often experience symptoms such as: Gas, stool or pus secreted from the vagina; vaginal discharge (gassing through the vagina during bowel movements); recurrent vaginal or urinary tract infections; irritation or pain in the vulva, vagina, and mid-vaginal-anal area (perineum); pain during sex.
Diagnosis of rectal fistula is mainly through clinical symptoms and clinical examination. The doctor can do a rectal-vaginal examination with a finger, see fistulas on a colposcopy and ano-rectal examination, and see stool in the vagina. To confirm the diagnosis, the doctor can put a white gauze pad into the vagina, inject methylene blue into the rectum, after 15 - 20 minutes when the gauze is taken out, you will see the gauze soaked in blue ink. To clearly identify the fistula status, it is necessary to use additional imaging methods such as: Contrast fistula, magnetic resonance imaging (MRI), computed tomography (CT scan) anal ultrasound. rectal or transvaginal ultrasound.

Obstetric trauma: Prolonged labor or obstetric procedures (forceps, aspiration, episiotomy ...) cause necrosis of the vaginal - rectal wall or complicated tear in the perineum causing fistula rectum - vagina; Infections: Complications of Crohn's Disease; Abscesses in the anterior wall of the rectum can rupture into the vagina to form a passage between the two organs; Bartholin's gland inflammation in the vagina can open into the rectum to form a rectal-vaginal fistula; inflammation of the pouches in the intestines ( diverticulitis ); HIV infection ; Cancer or radiation therapy to the pelvis: Cancer in the vagina, cervix, rectum, uterus, or anus can cause a rectal fistula. Radiation therapy for cancers in this area can also create a passage between the vagina and rectum; Surgery: Surgery on the vagina, perineum, rectum, or anus can cause injury or infection, creating an abnormal fistula between the vagina and the rectum; Other causes: Stool stuck in the rectum (fecal retention); tuberculosis, venereal disease, sexual abuse.

Incontinence of defecation; recurrent vaginal or urethral infections; Vaginitis, perineum, perianal skin; The fistula is abscessed, which can be life-threatening; Rectal-vaginal fistula recurrence.

Lifestyle habits to help control rectal - vaginal fistula include:
Clean the outside of the genitals with warm water when there is vaginal discharge or stool; Avoid using irritants such as strong, scented soaps and scented tampons, avoid douches, and use mild, unscented soaps; Dry the vagina with a clean, dry towel after cleaning; Avoid using dry toilet paper to clean the rectum - vagina. It is recommended to use paper towels or cotton swabs that are moistened, unscented and alcohol-free; Moisturizer, talcum powder or cornstarch can be used to protect the skin from irritation by vaginal secretions or stool as prescribed by the doctor; Wear cotton underwear and loose-fitting clothes, so dirty underwear should be changed frequently; Absorbent pads, disposable pads, or adult diapers may be used if fluid or stool is present. Patients should see their doctor as soon as they notice the warning symptoms of a rectal fistula, as this can be the first warning sign of a serious problem like an abscess or cancer to get a diagnosis. accurate and have the best treatment options.
Patients with rectal fistula can go to Vinmec International General Hospital for examination and treatment. There is a team of well-trained, professional and experienced gynecologists; system of modern equipment, meeting international standards; professional service quality, bringing satisfaction and comfort to customers.