Rectovaginal Fistula Surgery: What to Expect Before, During, and After the Procedure 

As a medical professional, encountering cases of rectovaginal fistulas can be challenging. These abnormal connections between the rectum and vagina can cause distressing symptoms for patients, including pain, fecal incontinence, and recurring infections. While non-surgical treatments may provide some relief, surgery is often necessary to repair the fistula and restore normal function. In this blog post, we'll discuss everything you need to know about rectovaginal fistula surgery - from what to expect before the procedure to potential complications afterward. So let's dive in!

Symptoms of Rectovaginal Fistulas

Rectovaginal fistulas can cause a range of distressing symptoms for patients. One common sign is the presence of fecal matter in the vagina, which may lead to recurring infections and a foul odor. Patients may also experience pain during bowel movements or intercourse, as well as chronic vaginal discharge.

Other symptoms of rectovaginal fistulas may include itching, burning, and irritation around the anus or vulva. In some cases, patients may develop recurrent urinary tract infections due to the close proximity of the affected areas.

It's important for medical professionals to be aware of these symptoms so that they can make an accurate diagnosis and provide appropriate treatment. While some cases of rectovaginal fistulas may resolve on their own or with non-surgical treatments such as antibiotics or sitz baths, surgery is often necessary to repair the abnormal connection between the rectum and vagina.

Treatment of Rectovaginal Fistulas

Treatment of rectovaginal fistulas depends on the size and location of the fistula, as well as its underlying cause. A small, uncomplicated fistula may heal on its own with proper hygiene and wound care. However, most cases require medical intervention.

The first line of treatment is usually conservative management with stool softeners, antibiotics to prevent infection, and sitz baths to promote healing. Surgery is recommended if conservative measures fail or if the fistula is large or complex.

Surgical options include a number of procedures such as transvaginal repair using local tissue flaps or biologic materials; sphincteroplasty for anal sphincter muscle damage; colostomy in severe cases where other treatments have failed; and laparoscopic approaches that offer less invasive options but are not suitable for all patients.

Radiology plays an important role in post-operative follow-up by detecting any recurrence or complications after surgery. Patients should also receive ongoing monitoring by their healthcare team to ensure optimal recovery and avoid potential complications.

In summary, there are various treatment options available depending on the severity and complexity of a rectovaginal fistula. It's important to consult with a medical professional experienced in treating this condition to determine the best course of action specific to each patient's individual needs.

Surgery for Rectovaginal Fistulas

Surgery is often the most effective treatment for rectovaginal fistulas. Before undergoing surgery, patients will need to undergo a thorough pre-operative evaluation to determine their overall health and the extent of the injury.

The surgical approach will depend on several factors such as the size and location of the fistula, its cause, and any underlying medical conditions that may be present. Generally speaking, surgeons will aim to close up the opening between the rectum and vagina using advanced techniques like laparoscopy or robotic-assisted surgery.

Post-surgical follow-up appointments are essential for ensuring that healing progresses smoothly and complications are identified early on. 

Complications of Rectovaginal Fistula Surgery

While rectovaginal fistula surgery can effectively close the abnormal connection between the rectum and vagina, there are potential complications that patients should be aware of.

One possible complication is infection at the surgical site. This may occur if proper hygiene measures are not taken during and after the procedure. Patients may experience fever or increased pain in the area as a result.

Another complication is bleeding, which can occur during or after surgery. This may require additional medical intervention to control. 

In some cases, nerve damage can occur during surgery which could lead to issues with bowel or bladder function post-surgery. The risk of this happening is relatively low but it's something patients should discuss with their surgeon before undergoing any procedure.

There is always a risk of recurrent fistulas despite successful closure of the original one. This means that another operation might be necessary down the line.

Patients considering rectovaginal fistula surgery need to understand these possible complications before making an informed decision about their treatment plan with their physician.

Conclusion

Rectovaginal fistula surgery is a complex and delicate procedure that requires an experienced surgeon. 

While rectovaginal fistulas can cause discomfort and inconvenience, it is important to address the issue sooner rather than later to prevent further complications from arising. With proper diagnosis, treatment, and surgical intervention if necessary, most patients can expect improved quality of life after undergoing this procedure.