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Sometimes after complicated childbirth a woman may develop symptoms that are difficult to explain immediately: unusual discharge, discomfort in the perineal area or a sensation that air or intestinal contents enter the vagina. The cause of this may be a rectovaginal fistula — a pathological channel between the rectum and the vagina. Through it gases or intestinal contents may enter the vagina, which causes physical discomfort, irritation of the mucous membrane and other unpleasant symptoms.
This condition requires mandatory consultation with a doctor, since it does not disappear on its own. Modern medicine has effective methods of diagnosis and treatment that help eliminate the problem and restore a normal quality of life.
The manifestations of the disease may differ depending on the size of the fistulous channel
and the causes of its formation. In some cases the symptoms appear gradually,
however sometimes they occur quite quickly and immediately cause
pronounced discomfort.
The most characteristic signs are:
passage of gas through the vagina;
entry of intestinal contents or mucus into the vagina;
unpleasant odor or irritation of the vaginal mucosa;
discomfort or pain in the perineal area.
Most often, a rectovaginal fistula occurs as a result of tissue injury or complications of inflammatory processes in the pelvic area.
The main causes include:
A fistula after childbirth may occur in the case of deep perineal tears that may involve the wall of the rectum. If such injuries heal incompletely or an inflammatory process develops, a pathological channel may form between the rectum and the vagina.
Sometimes postpartum fistulas do not appear immediately. The first symptoms may appear several weeks or even months after childbirth, when a woman may notice unusual discharge, the passage of gases, or intestinal contents entering the vagina.
If symptoms appear that may indicate a fistula between the rectum and the vagina, first of all it is necessary to consult a proctologist. This specialist is responsible for the diagnosis and treatment of diseases of the rectum and can assess the condition of tissues in the area of the anal canal and the perineum.
During the consultation, the doctor clarifies the patient's complaints, specifies when the symptoms appeared, and whether there were complicated childbirths, injuries, or surgeries in the pelvic area. After this, an examination and a digital examination of the rectum are performed, which makes it possible to suspect the presence of a fistulous tract.
To clarify the diagnosis, instrumental examination methods may be used:
If necessary, the proctologist may refer the patient for a consultation with a gynecologist. A joint examination makes it possible to more accurately determine the location of the fistulous tract and assess the condition of the vaginal tissues. Comprehensive diagnostics helps confirm the presence of pathology and establish a diagnosis, after which the doctor selects the optimal treatment strategy.
The treatment strategy depends on the size of the fistula, its location, the cause of its occurrence, and the condition of the surrounding tissues. In most cases, the fistulous tract does not close on its own, therefore the main method of treatment is surgical intervention. Medication therapy may be used only as a preparatory stage — to reduce inflammation, treat infection, or normalize bowel function before surgery.
Since rectovaginal fistulas may differ in size, depth, and structural features, the method of intervention is selected individually. Most often the following are performed:
Most operations are performed under spinal or general anesthesia to ensure complete absence of pain during the intervention. The duration of the procedure depends on the complexity of the fistula and the extent of the surgery.
In many cases, treatment is carried out in a hospital. Hospitalization may last from one to several days, after which the patient returns home and continues recovery on an outpatient basis.
After the operation, the doctor may recommend following a special diet that helps avoid constipation, limiting physical activity, and carefully maintaining perineal hygiene.
It is impossible to completely eliminate the risk of fistula formation, however some measures help reduce the likelihood of its occurrence. It is especially important to pay attention to prevention for women after complicated childbirth, surgeries in the pelvic area, or previous inflammatory diseases.
The main preventive recommendations include:
If a woman has already had a rectovaginal fistula and is planning pregnancy, it is important to remain under regular medical supervision. In such cases, pregnancy management with consideration of the previous disease is of particular importance so that doctors can monitor the condition of the tissues and, if necessary, choose a safe childbirth strategy.
The cost of rectovaginal fistula treatment is determined individually, since the treatment strategy depends on the characteristics of the disease. The price may be influenced by the size and location of the fistula, the surgical method, and its complexity.
In the proctology department of «Oxford Medical» in Kyiv, patients have access to modern medical services for the diagnosis and treatment of proctological diseases. You can ознакомиться with the prices in advance here.
Before planning the surgery, the doctor conducts an examination, evaluates the results of the tests, and determines the optimal treatment method. During the consultation, he will explain in detail the possible treatment options and guide you regarding the cost of the procedure. You can book an appointment at a convenient time for you — by phone or through the online booking form on the website.
In most cases, a rectovaginal fistula requires surgical treatment, since the fistulous tract usually does not close on its own. During the operation, the doctor removes the pathological tract and restores the integrity of the tissues between the rectum and the vagina. Timely consultation with a specialist allows selecting the optimal treatment method and reducing the risk of recurrence of the problem.
After the operation, it is important to create conditions for normal tissue healing. It is usually recommended to temporarily limit lifting heavy objects and intensive physical activity, follow a diet that ensures soft regular bowel movements (vegetables, cereals, a sufficient amount of water), and maintain careful hygiene. Following these recommendations helps reduce the risk of complications and promotes faster recovery.
Experienced doctors. Specialists with extensive experience in the diagnosis and treatment of rectal diseases who select treatment tactics taking into account the cause of the disease and the condition of the patient.
Comprehensive approach. If necessary, doctors of related specialties may be involved in the treatment, which allows a comprehensive assessment of the problem and the selection of the optimal treatment method.
Modern treatment methods. The clinic uses effective surgical techniques that allow eliminating the fistula and restoring tissues with minimally invasive access.
Comfortable inpatient care. If necessary, patients can undergo treatment in a modern hospital with comfortable wards and constant medical supervision after surgery.
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