Rectovaginal fistula: a review of 11 years experience

The records of 22 patients at Temple University Hospital with a diagnosis of rectovaginal fistula, from January 1970 to December 1980, were reviewed. The age at the time of diagnosis ranged from 18 to 75 years with an average of 47.3 years. Most had symptoms and signs which included fecal incontinence, flatus passage per vagina, tenesmus, distressing diarrhea and urinary tract infection. The majority of the fistulas were present for more than a year before the corrective operative procedure was attempted. The patients were divided into two groups: postirradiation fistulas and non-irradiation fistulas. The former resulted from the treatment of carcinoma of the cervix, urinary bladder, urethra, or rectum. The latter resulted from inflammatory bowel diseases, diverticulitis, or trauma from obstetric procedures. The former group were usually treated conservatively, either no operation or defunctioning colostomy. The latter group were treated more aggressively, either by direct repair or resection of the diseased segment.