A recto-vaginal fistula is an abnormal passage between the rectum and vagina, allowing the passage of feces or gas through the vagina, leading to discomfort. This condition can result from various factors, including childbirth injuries, surgical procedures, inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis, and tumors in the pelvic area.

Diagnosing a rectovaginal fistula usually begins with a thorough medical examination and detailed medical history. Additional diagnostic methods may include a colonoscopy, which allows for the inspection of the interior of the large intestine, and ultrasound for better visualization of the fistula. Dye testing or the use of smoke can be employed to confirm the presence and exact location of the fistula.

The treatment for a recto-vaginal fistula depends on its cause, size, and location. In many cases, conservative treatment may be recommended, which can include antibiotic therapy, dietary changes, and the use of tampons or diapers to manage symptoms. However, in most situations, surgical intervention is necessary for a permanent resolution of the problem.
Surgical techniques can vary from simple procedures involving the closure of the fistula to more complex reconstructive surgeries that restore the normal anatomy and function of the affected organs. In some cases, particularly when the fistula is a result of inflammatory bowel diseases, treating the underlying condition can lead to improvement or even closure of the fistula without the need for surgical intervention.