Rectovaginal fistula

Last revised by Mohammad Taghi Niknejad on 11 Jan 2024

Rectovaginal fistulae are a type of colovaginal fistula where there is an abnormal fistulous connection between the rectum and the vagina. It is considered the most common gastrointestinal fistula involving the female genital tract 1.

They can occur from a number of causes that include:

This may be seen as direct breach of the wall between the rectum and the vagina. An examination with contrast within the rectum is more helpful to confirm a tract. Fluoroscopy may be used, and an emerging technique is an MRI enema with gel used instead of contrast media. Some authors propose the use of CT vaginography 7.

Endoluminal sonography and endoluminal MR imaging are thought to have comparable positive predictive values in revealing the location of rectovaginal fistulas 2.

In the case of small amounts of intravaginal gas, this can often be seen with physiological situations 6 and rectal contrast examination is often useful for differentiation in clinically suspected cases.

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