ABSTRACT
Rectovaginal fistula is a distressing and troublesome condition manifested by passage of flatus and/or stool via the vagina. The condition is disabling and negatively impacts the woman’s quality of life. Rectovaginal fistulas are exceedingly difficult to treat and often pose a dilemma for the treating surgeon. Successful management is possible only after accurate diagnosis and complete assessment of the surrounding tissues is performed. Operative and non-operative trauma may also predispose women to Rectovaginal fistula (RVF) formation as well. Complications from various anorectal and vaginal operations can result in RVF near the dentate line, whilst more proximal RVF are usually secondary to pelvic operations. Inflammatory bowel disease, especially Crohn’s disease, may lead to spontaneous RVFs that are notoriously difficult to treat and carry a relatively high rate of proctectomy. Crohn’s-related RVF may occur in upwards of 10%–20% of women with Crohn’s disease.
