Presentation
They may present as a complication of vaginal surgery, including vaginal hysterectomy. They are a recognized presentation of rectal carcinoma or rarely diverticular disease of the bowel or Crohn's disease. [en.wikipedia.org]
Simple fistulas are usually small in size (≤0.5cm) and are present as single non-radiated fistulas. [ncbi.nlm.nih.gov]
At the time of presentation, Mrs. RH had been divorced. She was living with and supported by her parents. There was no abnormality detected on abdominal examination. [annalsafrmed.org]
Our patient in the video had previously underwent multiple various repairs which failed to provide adequate resolution of her fistula and therefore presented for a Modified Martius flap repair. [csurgeries.com]
Urogenital
- Foul Smelling Vaginal Discharge
Signs and symptoms of a rectovaginal fistula may include: Passage of gas, stool or pus from your vagina Foul-smelling vaginal discharge Recurrent vaginal or urinary tract infections Irritation or pain in the vulva, vagina and the area between your vagina [mayoclinic.org]
Neurologic
- Neglect
Other causes of VVF include urologic or gynecologic instrumentation, including percutaneous procedure, retroperitoneal, vascular or pelvic surgery, infectious and inflammatory diseases, foreign bodies (including neglected pessaries), sexual trauma, vaginal [ncbi.nlm.nih.gov]
Workup
Advanced Procedure Modified Martius flap for rectovaginal fistula Indications Repair of rectovaginal fistula after multiple failed attempts Contraindications Pre-existing dyspareunia (relative) Preoperative Workup CT scan, digital rectal exam, vaginal [csurgeries.com]
Treatment
Treatment for recto-vaginal fistulas includes either posterior sagittal anorectoplasty, as described above, or a minimally invasive (laparoscopic) pull-through procedure. [cedars-sinai.edu]
PMID 10449269. ^ "Rectovaginal fistula: Treatment and Management". Medscape. Retrieved 14 August 2012. ^ "Rectovaginal fistula Treatments and drugs - Mayo Clinic". www.mayoclinic.org. [en.wikipedia.org]
Natural Treatment For Fistula - Rectovaginal * Several years ago, I published an experimental treatment for healing fistulas in my book Listen To Your Gut. [listentoyourgut.com]
guidelines, discoveries in your fields of interest; be notified You are informed about innovative treatments, techniques and innovations in medicine This video is limited to doctors and other health professionals. [medtube.net]
A fistula caused by radiation usually forms within six months to two years after treatment. Surgery involving your vagina, perineum, rectum or anus. [mayoclinic.org]
Prognosis
Treatment and prognosis The usual management is surgical with primary resection and anastomosis 4. A conservative management approach may be adopted for poor surgical candidates. [radiopaedia.org]
Hospital-based reports show the incidence to be between 0.6 and 6.5 per 1,000 births. [5] Prognosis The success rate of vesicovaginal and ureterovaginal fistula repair approaches 90% at first attempt and approaches 100% after a second attempt. [emedicine.medscape.com]
Surgical treatment and prognosis of rectovaginal fistulae according to their origin. Zentralbl Chir. 2012; 137 (4):390–395. [ncbi.nlm.nih.gov]
Etiology
The most common etiology is obstetric injury, followed by radiation injury, inflammatory bowel disease ([IBD], most often Crohn disease), operative trauma, infectious etiologies, and neoplasm. tags: recto-vaginal fistula fistula cancer colonoscopy rectum [medtube.net]
Etiology The etiology of VVF varies and may broadly be categorized into congenital or acquired, the latter being divided into obstetric, surgical, radiation, malignant, and miscellaneous causes. [ncbi.nlm.nih.gov]
For those patients whom surgery is indicated, there are several different approaches depending on the fistula etiology and previous attempts at repair. [csurgeries.com]
Etiology In the United States, more than 50% of vesicovaginal and ureterovaginal fistulas occur after hysterectomy for benign diseases such as uterine fibroids, menstrual dysfunction, or uterine prolapse. [emedicine.medscape.com]
Epidemiology
Epidemiology A systematic review over a 35-year period reported 83.2% of fistula in developed countries were iatrogenic whereas 95.2% of fistula in developing countries were the result of obstetric complications. [3] However, the incidence of vesicovaginal [emedicine.medscape.com]
Epidemiological determinants of vesicovaginal fistulas. Br J Obstet Gynaecol. 1983; 90 :387–391. doi: 10.1111/j.1471-0528.1983.tb08933.x. [ PubMed ] [ CrossRef ] [ Google Scholar ] 7. Hilton P. Surgical fistulae and obstetric fistulae. [ncbi.nlm.nih.gov]
Pathophysiology
Pathophysiology Unrecognized bladder injury during a difficult hysterectomy or cesarean delivery may result in vesicovaginal fistula formation. [emedicine.medscape.com]
Prevention
In some cases, a preventive intestinal derivation for at least 3-6 months is necessary and is the only possible and definitive therapy. [ncbi.nlm.nih.gov]
The authors theorized that the larger opening prevented occlusion of the newly formed orifice, a feature that may make the window operation more advantageous than the marsupialization procedure. [aafp.org]
Vaginal infections are usually prevented by the protective bacteria (lactobacilli) that normally live in the vagina. These bacteria keep the acidity of the vagina in the normal range. [msdmanuals.com]