Rectoperineal fistula

Many people do not know much about rectal perineal fistula. The causes of this condition are mainly congenital and acquired reasons. Vaginal gas and defecation often occur. This is a relatively serious disease and there is no way to recover on its own. It can only be treated through surgery. This type of surgery is relatively difficult to treat and may lead to some recurrence rates. Let's take a look at this aspect.

Rectoperineal fistula

Rectovaginal fistula (RVF) is a congenital or acquired channel between the epithelial surfaces of the rectum and vagina and is relatively rare in clinical practice. The main clinical manifestations are vaginal flatulence and defecation, and in severe cases, uncontrollable bowel movements. It is generally not self-healing and most patients require surgical intervention. Due to the particularity and complexity of the local anatomy of the lesion site, surgery is difficult. If not handled properly, it will lead to repeated infections and high recurrence rates, often causing patients unspeakable pain and a decline in quality of life.

1. Natural childbirth

The occurrence of rectovaginal fistula is closely related to perineal tear, rectal tear, episiotomy, improper suture, etc. during natural delivery. It has been reported that the incidence of rectovaginal fistula in women who give birth vaginally is 0.1%.

2. Complications after stapler surgery

In recent years, the high frequency of use of staplers in rectal surgery has led to an increasing trend of rectovaginal fistulas caused by surgical injuries.

3. Inflammatory injury

Bacterial inflammation, chemical drugs and radiation-induced enteritis, etc., lead to local tissue ischemia and necrosis, forming rectovaginal fistula.

4. Complications of surgery

During hemorrhoid surgery or local injection of sclerotherapy, local damage caused by the surgery or improper injection site and dosage of injected drugs can cause local necrosis and later form a rectovaginal fistula.

5. Perianal abscess

Perianal abscess forms rectovaginal fistula.

6. Congenital rectovaginal fistula

It often coexists with anal atresia.

7. Cancerous fistula

Late-stage malignant tumors in the internal genitalia and pelvic cavity lead to local infiltration, metastasis, and tissue ulceration, leading to the formation of recto-vaginal tumor fistulas.

8. Diabetic patients

Diabetic patients are prone to infection and rectovaginal fistula. If blood sugar is not well controlled, it will affect the healing of the patient's wounds and skin and aggravate the infection.

Clinical manifestations

1. If the fistula is small, gas is often discharged from the vagina, and formed stool is often not discharged from the vagina. However, when the patient has diarrhea, defecation and gas may occur in the vagina.

2. If the fistula is large, stool and gas are often discharged through the vagina. Due to long-term irritation of the perineum by feces and vaginal secretions, skin ulcers and eczema may appear on the vulva, perineum and inner thighs.

3. Most of the patients' systemic symptoms are not obvious, and a few patients may have abdominal pain and low fever.

prevention

1. Treat perianal abscess and anal fistula promptly to avoid long-term recurrence and formation of rectovaginal fistula.

2. Standardized surgical procedures and avoiding recto-vaginal trauma as much as possible are crucial to preventing traumatic RVF.

3. Develop good living habits, have regular bowel movements, take a sitz bath after daily bowel movements, keep the perineum and anus clean, prevent and treat constipation and diarrhea, and avoid the occurrence of intestinal flora imbalance, which plays a positive role in preventing infection.