Rectovaginal Fistula

Rectovaginal fistula is an abnormal connection between the rectum and the vagina. Gas or stool may leak from the bowel into the vagina.

  • Causes

    A rectovaginal fistula is caused by an injury to this area. It may be caused by physical trauma or a medical condition.

  • Definition

    Rectovaginal fistula is an abnormal connection between the rectum and the vagina. Gas or stool may leak from the bowel into the vagina.

    Healthy Wall Between Vagina and Rectum
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  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may need to see a colon and rectal surgeon.


    Tests may include the following:

    • Anorectal ultrasound—a small wand-like instrument provides a video image of the rectum and anus
    • Methylene enema—a tampon is placed in the vagina and methylene blue is placed into the rectum to identify movement of fluid from rectum to vagina

    • Contrast studies—
      barium enema
      may be used to view a rectovaginal fistula that cannot be seen on physical exam
    • Endoscopy—a thin, lighted tube is inserted into the rectum to examine the rectum and the lower colon (to rule out irritable bowel disease)

  • Prevention

    There are no steps to prevent rectovaginal fistula.

  • Risk Factors

    Factors that may increase your risk of rectovaginal fistula include:

    • Crohn’s disease
    • Complications following surgery to the perineum (area between vagina and rectum), vagina, rectum, or anus
    • Injuries during childbirth
    • Radiation treatment or cancer in the pelvic area
    • Perianal infection

  • Symptoms


    If you have any of these, do not assume it is due to a fistula. These symptoms may be caused by other conditions. Talk to your doctor if you have:

    • Passing stool or gas via the vagina
    • Inability to control bowel movements
    • Foul-smelling vaginal discharge
    • Recurring vaginal infections
    • Pain during sexual intercourse
    • Persistent pain in the pelvic area

  • Treatment

    Talk with your doctor about the best plan for you. Treatment options include the following: