Rectovaginal Fistula Repair
A rectovaginal fistula is a vaginal fistula (passage or hole) that opens into the rectum. It starts with some kind of tissue damage that ultimately causes a tissue breakdown. It sometimes happens after surgery, a period of inflammatory bowel disease such as Crohn’s disease, ulcerative colitis, or diverticulitis, or a deep tear in the perineum or infected episiotomy after childbirth. Surgery is most likely needed to repair it.
Before surgery, the skin and other tissue around the fistula must not be infected or inflamed. Antibiotics may be necessary to heal infection. The goal of surgery is to remove the fistula tract and close the opening by sewing healthy tissue together. The type of operation depends on the size and location of the fistula. Options include:
- Sewing an anal fistula plug or patch of biologic tissue into the fistula to prompt tissue to grow into the patch
- Using a tissue graft taken from a nearby part of the body or creating a flap to cover the fistula
- Repairing the anal sphincter muscles if they’ve been damaged or if scarring has occurred
- Performing a colostomy before repairing the fistula to divert stool through an opening in the abdomen instead of the rectum, in cases of complex or recurrent fistulas