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Rectovaginal Fistula Treatment

Rectovaginal fistula is an abnormal connection between the rectum and vagina causing passage of stool or gas through the vagina. Pristyn Care offers expert minimally invasive surgical repair with high success rates.

Rectovaginal fistula is an abnormal connection between the rectum and vagina causing passage ... Read More

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    Dr. Galla Murali Mohan - A general-surgeon for Anal Fistula

    Dr. Galla Murali Mohan

    MBBS, MS-General Surgery
    34 Yrs.Exp.

    5.0/5

    34 Years Experience

    location icon Pristyn Care Archana Hospital, Madeenaguda, Hyderabad
    Call Us
    080-6542-3724
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    Dr. Vipin Nagpal - A general-surgeon for Anal Fistula

    Dr. Vipin Nagpal

    MBBS, MS-General Surgery
    31 Yrs.Exp.

    5.0/5

    31 Years Experience

    location icon Pristyn Care Elantis Hospital, Lajpat Nagar, Delhi
    Call Us
    080-6542-3711
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    Dr. Rakesh Shivhare - A general-surgeon for Anal Fistula

    Dr. Rakesh Shivhare

    MBBS, MS(GI & General Surgeon)
    30 Yrs.Exp.

    5.0/5

    30 Years Experience

    location icon Opp.Badwani Plaza, Manorama Ganj, Old Palasia, Indore, Madhya Pradesh 452003
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    080-6542-3720
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    Dr. Apoorv Shrivastava - A general-surgeon for Anal Fistula

    Dr. Apoorv Shrivastava

    MBBS, DNB-General Surgery
    25 Yrs.Exp.

    4.5/5

    25 Years Experience

    location icon Pristyn Care Eminent Hospital 6/1 Opp. Barwani Plaza, Manorama Ganj, Old Palasia, Indore - 452018
    Call Us
    080-6542-3720

What is Rectovaginal Fistula?

Rectovaginal fistula (RVF) is an abnormal communication between the rectum and the vagina, allowing passage of faeces and gas through the vagina. It can result from obstetric injury, Crohn’s disease, radiation, or surgical trauma. RVF causes significant physical and psychological distress and requires specialised surgical expertise. Pristyn Care colorectal surgeons offer advanced sphincter-preserving repairs with excellent outcomes.

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Symptoms

Symptoms of Rectovaginal Fistula include:

  • Passage of stool or gas through the vagina
  • Foul-smelling vaginal discharge
  • Recurrent vaginal or urinary tract infections
  • Perianal or perineal pain
  • Skin irritation around the vaginal opening
  • Psychological distress and impact on quality of life
  • Difficulty maintaining hygiene

Are you going through any of these symptoms?

Causes

Rectovaginal fistula can be caused by:

  • Obstetric injury — most common cause, especially third or fourth degree tears
  • Crohn’s disease or inflammatory bowel disease
  • Radiation therapy for cervical, rectal, or uterine cancer
  • Surgical complications from hysterectomy or rectal surgery
  • Trauma or perineal injury
  • Infections or perianal abscesses

Types of Rectovaginal Fistula

Classified by location:

  • Low RVF — between the lower rectum and lower vagina (most common)
  • Mid RVF — between the mid-rectum and mid-vagina
  • High RVF — between the upper rectum and posterior vaginal fornix
  • Complex RVF — associated with Crohn’s, radiation, or previous failed repairs

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Risk Factors

Risk factors for Rectovaginal Fistula:

  • Complicated vaginal delivery or obstetric trauma
  • Crohn’s disease or inflammatory bowel disease
  • Pelvic radiation therapy
  • Previous anorectal or gynaecological surgery
  • Infections or perianal sepsis

Who is at Risk?

Rectovaginal fistula primarily affects women of childbearing age following complicated vaginal deliveries. Women with Crohn’s disease, those who have undergone pelvic radiation, or those with prior pelvic surgery are also at increased risk.

Diagnosis

Diagnosis of Rectovaginal Fistula involves:

  • Vaginal and rectal examination
  • Methylene blue or hydrogen peroxide dye test
  • MRI pelvis — best for complex or high fistulas
  • Endoanal or endovaginal ultrasound
  • Colonoscopy to rule out Crohn’s disease
  • Examination under anaesthesia (EUA)

Treatment for Rectovaginal Fistula

Treatment depends on the cause, location, and complexity of the fistula. Small fistulas may heal with conservative management. Most cases require surgical repair via transanal, transvaginal, or transperineal approaches. Complex cases may need a diverting stoma to protect the repair.

Transanal Advancement Flap Repair

Transanal advancement flap repair for RVF:

  • Patient positioned under general or spinal anaesthesia
  • A flap of healthy rectal mucosa and muscle is raised
  • The fistula opening in the rectum is excised and closed
  • The advancement flap is sutured over the defect
  • The vaginal opening is left to drain
  • Sphincter is preserved with minimal risk of incontinence
  • High success rate in low and mid RVF

After the Surgery

Post-operative care after RVF repair:

  • Low-residue diet in the first week post-surgery
  • Sitz baths for wound hygiene
  • Stoma care if a diverting stoma was created
  • Prescribed antibiotics and pain relief
  • Avoid intercourse for 6-8 weeks post-repair
  • Follow-up examination to assess fistula closure

Complications | Rectovaginal Fistula Surgery

Potential complications of RVF repair:

  • Recurrence — especially in radiation-related or Crohn’s fistulas
  • Wound infection or breakdown
  • Faecal incontinence if sphincter is affected
  • Persistent sepsis or abscess
  • Dyspareunia (painful intercourse) post-repair
  • Need for repeat surgery or stoma creation

Frequently Asked Questions

What is Rectovaginal Fistula?

Rectovaginal fistula is an abnormal passage between the rectum and vagina that allows stool and gas to pass through the vagina, causing significant distress and hygiene problems.

Can Rectovaginal Fistula heal on its own?

Small post-obstetric RVFs may occasionally heal with conservative management including good nutrition and bowel rest. However, most require surgical repair for permanent closure.

What is the best surgery for Rectovaginal Fistula?

The transanal advancement flap repair is the most effective procedure for low and mid RVFs. Complex or recurrent fistulas may require more advanced techniques or a diverting stoma.

How long is recovery after RVF repair?

Most patients recover within 3-4 weeks after RVF repair. Intercourse should be avoided for 6-8 weeks. For complex cases requiring a stoma, full recovery may take several months.

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Medically Reviewed By
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Dr. Galla Murali Mohan
MBBS, MS-General Surgery
34 Years Experience Overall
Last Updated : April 29, 2026

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