Characteristics, management, and outcomes of repair of rectovaginal fistula among consecutive cases of genital tract fistula in Ethiopia. Accessed Aug. Schwartz DA, et al. The role of imaging tests in the evaluation of anal abscesses and fistulas. Fecal incontinence. National Digestive Diseases Information Clearinghouse. Toglia MR. Rectovaginal and anovaginal fistulas. Genital fistulas in female Crohn's disease patients: Postcoital Vaginoperitoneal Fistula After Hysterectomy For Gynecological Malignancy characteristics and response to therapy.
Journal of Crohn's and Colitis. Four patients had received neoadjuvant radiotherapy. The mean time from injury was Department of Urology. How does Postcoital Vaginoperitoneal Fistula After Hysterectomy For Gynecological Malignancy VVF occur?
When does a VVF present? How is a VVF diagnosed? How is a ureterovaginal fistula UVF diagnosed? Evaluation of the ureter is always part of the VVF evaluation. What is the best timing for VVF surgical repair? A CT scan may also be performed if there are no clear, non-malignant causes for a suspected fistula. The best treatment option for rectovaginal fistula depends on a number of factors including the cause of the fistula, the severity of symptoms, and a person's overall health.
For example, at least one study has found that half of small fistulas caused by obstetrical trauma heal on their own within six to nine months. However, this only works for women with minimal symptoms that are easy to manage. Before any more invasive treatment for rectovaginal fistula, it is important to eliminate any infections or inflammation. As such, your healthcare provider may treat you with antibiotics. They may also insert a tube called a seton to allow your fistula to drain safely and reduce inflammation.
The seton is usually removed at the time of fistula repair. The surgical procedure that is the best choice for you will depend on a number of factors, including whether you have previously undergone a repair. Repair can either be performed on the rectal side of the fistula or the vaginal side of the hole. In some cases, temporary fecal diversion through a stoma may be part of surgical fistula repair and healing. There are also more experimental procedures for rectovaginal fistula repair.
These include the use of fibrin glue and fistula plugs. Fistula plugs are, however, more often used for repairing other types of fistula. It can be difficult to cope with a rectovaginal fistula. In severe cases, constant fecal and urinary leakage can lead to issues with odor as well as damage to the vulva and thighs. Some women, particularly in the developing world, have reported being socially ostracized. Rectovaginal fistula can also cause problems in intimate relationships.
Due to all of these factors, and other potential Postcoital Vaginoperitoneal Fistula After Hysterectomy For Gynecological Malignancy associated with rectovaginal fistula, depression is common both before and after diagnosis. Fortunately, in the Western world, there are numerous options for fistula treatment and repair.
However, because of the intimate nature of this problem, it's still a good idea to seek support. You may want to find a support group of other women who have experienced similar conditions. It may also be helpful Postcoital Vaginoperitoneal Fistula After Hysterectomy For Gynecological Malignancy find an individual therapist with whom you can share your concerns.
Finally, sex and relationship therapy may be a good option for women who have experienced intimacy problems after a rectovaginal fistula or repair. These problems can be difficult to talk about with a partner, and it never hurts Postcoital Vaginoperitoneal Fistula After Hysterectomy For Gynecological Malignancy have help.
Furthermore, vesicovaginal and ureterovaginal fistulas may complicate the postoperative period. In addition, infrequent causes of vaginal leukorrhea and discharge after hysterectomy include: colovaginal fistula, lymphatic vaginal fistula, fistula from the fallopian tube remnant, and the leakage of peritoneal fluid.
Surgical treatment is necessary in this condition, with the removal of inflammatory and granulated tissue and the repair of the vaginoperitoneal fistula. In our opinion, the preferable surgical approach is laparoscopic, but successful surgery may be achieved by a laparoscopic, vaginal, or combined approach. The challenge is, however, to prevent vaginoperitoneal fistula and fallopian tube prolapse from occurring after hysterectomy.
The prevention of pelvic hematoma, use of prophylactic antibiotics, careful suturing of the vaginal cuff, and avoiding vaginal vault drains are probably of great importance. Coincidal salpingectomy or fixation of the adnexa in the pelvic lateral wall in connection with hysterectomy is more questionable. J Am Assoc Gynecol Laparosc — Obstet Gynecol Postcoital Vaginoperitoneal Fistula After Hysterectomy For Gynecological Malignancy PubMed Google Scholar.
A report of two cases. J Reprod Med — JAMA —
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