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This thread is an extension of the Rectal Vaginal Fistula thread. Please continue posting within this thread.

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Rooney...that sounds like my story to a tee...the whole my dr. should have done a c-section...but didn't...and now have suffered 8 surgeries and am still not back to normal.

Currently, I have a perianal fistula, which is just an extra tract from my rectum (above the sphincter) to my perineum. I have left it alone for 4 months, hoping that it was just closing up on it's own since after my failed plug repair, the pain went away for a while.

Now it's been getting really sore, and for the first time in a while, I actually reached down there and felt to see if there were any absesses, and I felt something really weird. When I look now, I can see something protruding from the fistula hole, just a little, but something nonetheless!! It hurts really bad to the touch...and I feel like my whole perineum is collapsing...kinda like when my sphincter was disconnected...

My fear right now is that I think I might be having an anal prolapse through my fistula tract. Is that even possible??

I take antidiahrea every day b/c I was on constipating pain killers for so long that I get diahrea pretty instantly if i don't take them every day...so for a while I was getting really constipated and pushing pretty hard.

Anyway...I feel for everyone here who has to deal with this c**p...and Rooney, I wish I had talked to you a few years ago, b/c I looked into suing, and no-one wanted to take my case b/c it was not open and shut and it's hard to prove fault...

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I just found this site -- THANK YOU to all of you who have posted! Like many of you, I have also felt alone and self-conscious in this.

Can any of you recommend websites that explain the various repair options? What are the plug and button approaches that some of you have mentioned?

I have been living with an RVF for nearly 16 years, following 4th degree tearing while delivering a 9lb 4oz baby (1991). I checked into getting it repaired by a colorectal surgeon about 3 months after the birth (spring 1992) , but when I asked about the safety of the postsurgical constipating drugs, he said, "We'll have to see if we can find some drugs that won't affect your baby." For a nursing mother, that "if" was a huge turn-off. Then I found out that a resident would be doing the surgery and decided not to go through with it.

In 1992, my second (smaller!) baby was also born vaginally. My plan was to let the site re-tear and then re-do the repair, which my doctor thought could succeed because of the increased blood supply to the region during pregnancy. It didn't. The fistula reformed, larger than before. Being very careful about cleanliness has helped me avoid yeast infections and UTIs (only two in 16 years).

Three years ago, I looked into repair again. This time the repair would include a diverting colostomy, an OBGYN and a general surgeon. I found a very positive site about living with -ostomy, but was completely turned off by the idea of living with it myself, even temporarily, as well as having a second surgery only 6-8 weeks later to reverse the colostomy. Too much surgery for me, plus a scar as a permanent reminder.

I've looked online for repair methods, trying to educate myself before checking into repair again. So far, no luck finding options. I'm hoping some of you can point me in the direction of information.

Thank you!

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You could ask your colorectal surgeon about these other options (BTW - I would ONLY allow a colorectal surgeon do any procedure. You were smart to not have it done with an intern!):

Mucosal Advancement Flap

Surgisis Plug, I think they have a new one with a button on the end to hold it in place. They usually put a few stitches.

Perianal reconstruct, with or without the sphincter overlap repair.

Do you know if your connection goes through your musle? And how is your control?

If your muscle is ok, I would leave it alone, and just try to get the hole fixed, etiher with the plug (which has a very low success rate, I've had 2 fail), or you can ask about the mucosal advancement flap. I had mine done from the rectal side, they cut a flap and pull it down over the hole...it's delicate...but could work.

The colostomy is probably just to keep the area clean and to keep you from having to strain during any repair recovery you decide to have done. It's an interesting option that I was never offered, and never really thought about, but probably wouldn't have opted for either. I have had all of the above procedures done, and now have to decide what to do next because I have a new fistula which developed after my sphincter repair.

I had some ano-rectal testing done this morning and am waiting on results to find out how my muscles and nerves responded to the "probing." The ultrasound was very interesting to see. I have a perinanal fistula that goes right through my sphincter muscle, so I only have a few options...do nothing and suffer as it is, try plug after plug to see if they eventually work, of have a full reconstruction done AGAIN of my perineum/sphincter.

This by far was the WORST surgery I've ever had to deal with, very painful, very hard recovery, and the dr can't guarantee that the problem won't come back...or that I won't lose control again...so I don't know what to do about it...

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I would like to know if anyone has gotten an RVF that was not due to the vaginal delivery of a child?

I was diagnosed w/a perirectal abscess in June '06 and I was told that a RVF was possible after my surgery to remove the abscess. And as it usually is for me, if there can be a problem, there will be. As I was being admitted to the hospital for the abscess surgery, the abscess ruptured in my vagina. I was told by my surgeon that this would heal by itself as would the two other holes that he cut to drain the abscess. Well needless to say a fistula has now developed. I am having gas and stool pass through my vagina.

With all of the posts, I am beginning to think that my chances for 100% repair are pretty slim.

Any suggestions on which would be the best possible repair?

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Thank you, Shellsue. I appreciate having some options to read up on before meeting with another doctor.

How were the results of your testing? Was there any information that points to a repair method with a high chance of succeeding for you??

A doctor a few years back told me that I was lucky to have as much rectal control as I do (almost as good as before childbirth) after two spincter tears. She did tell me, though, that I have a thin perineal body, which could eventually lead to bladder prolapse.

It's said that childbearing changes a woman's body forever, but no one ever mentioned any of this!

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I had a hysterectomy that resulted in a RVF. My doctor accidentally cut into my rectum. The hysterectomy started out be vaginal, but she decided to complete it abdominally. I noticed the RVF 4 days after the hysterectomy. I went to a colorectal surgeon, who performed a repair of the RVF and also performed an ileostomy to allow for healing of the repair. I have about a month to go before tests are done to determine if the repair has healed. If it has, I will have another surgery to do the ileostomy repair. It has been a rough road, both physically and emotionally. I would not wish this on anyone.

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My test results came back and it looks like I have good sphincter resting tone, which is what someone else mentioned...being surprised about how much control they had after these surgeries...what I don't have is much of a squeeze strength...so if I can't hold something in, I can't hold it in, and I don't think this will ever get better without a surgery. The ultrasound showed that both my inner and outer sphincter muscle rings are defective, meaning they are not attached fully and are not working to capacity. This really surprised me since that is what I had fixed (sphincter overlap) and suffered through for 8 months...

After talking to the dr and discussing our options, I have decided to leave things alone for now and deal with the situation as it is. I really don't want to put myself through another reconstruction only to be back to where I am now, or worse since she would be going through my muscle for the 4th time, and I already don't have much to work with. The dr. didn't sound too confident in anything she wanted to do, and I figure if the surgery didn't hold the first time, why bother again a second time right?

am64 Did you meet with your dr. about other options? What did you come up with??

Jaidynsmom - that sucks that your absess turned into RVF! I'm so sorry you have to go through this. There are always chances that the less invasive surgeries will work, so before having a full reconstruct done, you may want to opt for the surgisis plug first. That is pretty uninvasive, an outpatient surgery with a semi-delicate recovery.

If that doesn't work, there are other options that I mentioned in my previous post. I'm not sure where to even tell you where to begin, but it doesn't sound like the RVF is through your sphincter muscle, which may be a plus, but if it is, it may be a bit more complicated to repair.

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Has anyone had problems with fistulas or episiotomies re-opening years later? After having my first child and being torn six ways to Monday, I had three more C-sections to avoid going through that again. Now, almost 18 years after my only vaginal delivery, I'm noticing blood again (and have for a month or so now) in a straight line along the perineum. It's definitely not menstrual, so I'm a little worried that something may have opened up again.

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Unfortunately, I haven't experienced that b/c I've yet to be back to normal...but, maybe someone else?

I would think it might be possible if when you were repaired years ago, there was still a small pocket, and just developed another...

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I know my story is like most on here,,,but i just really need someone to talk to about all of this
Well, I had my daughter back in 2004...well i ended up having a 4th degree tear with my episiotomy.
Well after i had gone for my 6 week check up,,,they said it healed up nicely...well im not sure how long after that ,,that i realized that there was stool coming out of the wrong place...at first i thought it was that brownish blood kinda spotting between periods,,,but soon realized it wasn't....and also noticed that gas would come through too.
Well i mentioned it to my ob/gyn (not the one the delivered her) and she said yeah that happens sometimes,,,but just excersize and eat good...
so i was like ok,,,i guess i just have to deal with this. It didnt hurt like others stories i have read ,,it is just the passing of stool and gas.
Sorry this is so long,,,well just this year i switched ob/gyns and i mentioned this to him,,,and he said that he did notice what he thought may be stool in the vagina,,,and quickly refered me to a colorectal surgeon.
Well i ended up going and he did an exam in the office trying to see if he could feel it,,,he couldn't , but said that the wall between the two was very thin.
So he set me up to have a Flex Seg...its like a partcial colonoscopy,,,,,this app was with his wife who is also in practice with him....she said she didnt see anything,,and that it looked normal....well they had scheduled some Contrast Enema thing but needed to do a colon cleanse the day before....well after the flex seg i didnt really feel like she talked with me very much to inform me of what was going on,,and help inform me of what this other test was,,so i ended up canceling the app,,,and made an app to talk to her first.
So i took my mom with me to talk to her on thursday,,,and she said she thinks i just need to do this high fiber diet and wear a tampon for a while to see if i can see on there where it is coming through...she seems to think that i "think" it is coming out of my vagina and really isnt,, it may just be "smeary" and getting everywhere,,,and as far as the gas it could be caused from the thin wall or area between the two,,it may make it feel like a vibration...
So at first i was like ok,,,that sounds good,,,hopefully this fiber works....but as i think more about it and really pay attention,,,,,there is no way there is not an opening somewhere in there,,,,and i persoanly think it is very very low just above the surface,,and i think they were just looking too high for it,,,or maybe it is only visible with pressure...
Well anyway,,i just wanted to talk to someone who maybe has delt with this,,and could i be wrong about the fistula? could the dr. be right? it just seems really unlikly having delt with this for 4 years,,i think i would know.
well any help you could give would be greatly appreciated.!
And also what kind of tests or exams were done to determine if and where exactly your fistula was? Im just feeling like the dr. thinks im stupid and i dont know what im talking about cause im only 23,,,,i just know this is not normal.

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I am new and can not believe how many women this has happened to. I'm so sorry that everyone on this board has had to suffer through all that they have. You are all in my prayers. I wish I would have found this website 3 years ago. I thought I was suffering alone, with the exception of women in 3rd world countries. I may not be posting correctly but if not let me know where i should. I am in the process of sueing, I am not a sue happy person, but I have to get these dr bills paid. I have zero stretch marks and no morning sickness during pregnancy but my delivery ended up horrible and my health will nver be the same

I had to get a colostomy due to child birth 1 week after my son was delivered via c section after pushing for 2 hours and receiving a 4th degree episiotomy. the doctor used forceps and suction devices, fortunately my son was not harmed in the delivery. My story is long due to it being taken from the letter I sent to my attorney less than a month from delivering my child. My child was born in Jan 05, it has taken this long to get a court date set. the court date is still over a year away.

I have deleted names but please be patient with me, it is very long this is my story of my fasmily and my childs first 2 weeks

I gave birth to my son on a Sunday, I received a stage 4 episiotomy after pushing for nearly 2 hours and the Dr. tried to suction the baby out several times 4or 5 times with different suction devices as well as using forceps 2 times, he decided to deliver the baby by C-section. My tailbone was tilted forward and the baby could not get past it. The dr. stated that he had never had a baby get that far down and not be able to deliver vaginally. Before we left for the operating room he sewed up my episiotomy, stating that “I’m having a hard time getting these last stitches, the baby’s head is right there.”
The nurses would ask about passing gas or having a bowel movement I would respond that “No, I have not passed gas; however, I am having air come out of my vagina.” The nurses would state that could be because I pushed for 2 hours trying to get the baby out, and air could have gotten trapped in there.
I was discharged on a Wed, while breastfeeding that morning I became much overheated. I didn’t think anything of this; I relaxed for a while and I decided to take a shower. I again became overheated and felt like I was going to pass out. I got out of the shower and had to lie down before getting dressed. I called the nurse and asked her to take my vitals and I told her “I really don’t feel good” my vitals were normal and I just thought it must be stress. My husband was packing everything and preparing for us to be discharged
the RN whom discharged me from the hospital was going over all the discharge stuff, while I was lying in the bed. I told her, again that I did not feel well; she stated “Maybe you should let your doctor know on your next checkup, you are probably just tired.” I was not able to help my husband pack up the things to get ready for discharge. I was discharged from the hospital; I never once passed gas or had a bowel movement after having a C-section. After getting in the car, we were leaving the parking lot and I had to call the nurses station to ask if she had given me my prescriptions, she stated that “she had put them in my discharge packet.” I honestly could not remember anything she had gone over with me about my discharge. I was feeling really out of it. We picked up my prescriptions on our way home, I was just happy to be home with my new family. That night, I continued to feel lethargic, and just not myself
About 8:00pm I was nursing my son and got chills really bad. I had to put on several layers of clothing to get comfortable. I told my husband that it was probably normal since my milk had just came in a few days ago, neither of us had ever had any experience with breastfeeding and we were unsure of the side effects.

I woke up the day after my discharge feeling exhausted. At around 1:00pm, I decided to take a nap, I had no energy. I woke up at 2:15pm and I had a difficult time getting out of bed. My lower back and abdomen were hurting so bad that I could barely walk. I continued to hurt and hobble around until my husband got home. I continued to have a bad backache, stomachache and headache, I asked my husband to go to the store to purchase a heating pad. I lay on the heating pad for about 20 minutes and I again got the chills really bad. I decided to take my temperature; I had a fever of 101.9. I took a percocet and waited about an hour and took my temperature again, it was 101.4. I called my friend who was my delivery nurse and asked her if these symptoms were normal for just having a baby, stage 4 episiotomy and C-section. She then asked if I was passing gas and or having bowel movements. I told her about not passing gas and the air escaping my vagina and she stated, “if you don’t pass gas or have a bowel movement by the tomorrow, you need to see you doctor.”
It had been since the night my water broke that I had had a bowel movement, which was 5 days ago. So I called the after hours line, the Dr. said “If you have a temp of almost 102, you should go to the emergency room; I do not feel comfortable calling in antibiotics because I’m not sure what I would be treating.” After a few minutes of his insisting that I go to the ER, and my husband, I finally agreed to meet him at the ER.

I arrived at the ER around 11:00pm. A CAT scan was performed on me, it showed that I had “uterine debris” and I was admitted and taken to my room I was also informed that due to the CAT scan, that I would have to continue to pump my breast milk but I would have to throw it away for 48 hours.

I was later informed that my newborn baby could stay in the hospital room with me as long as I had an adult with me take care of him at all times. I was glad because I was breastfeeding and did not want to be away from him. He wasn’t even a week old.

On Friday My OBGYN, (not the same as the delivery dr ) performed a vaginal and rectal exam on me and discovered that I had a fistula between my vagina and rectum. The exam was very excruciating. (I had just received stitches in my rectum and vagina from the episiotomy as well as trying to push out a 9 lb 1 oz, 22 inch baby for nearly 2 hours.) He stated, “this doesn’t happen very often and I need to converse with a few colleagues to figure out how to fix it.” I asked how it happened and he stated, “I’m not sure.” I asked, “Would I have had this problem eventually if I had not gotten pregnant?” He responded, “No probably not.” I again asked, “how or why this happened, I did not have any pregnancy complications, morning sickness, not even 1 stretch mark, the only side effect I had the entire pregnancy was reflux.” He again stated, “I do not know why this happened.” As a matter of fact, I questioned several nurses and other staff during my hospital stay and each of the persons I was talking to was very hesitant to answer my questions. There was a lot of I don’t know you will have to ask your doctor. My OBGYN later came to my room to tell me “that anther dr would be in later to examine me.” He explained that this dr’s specialty was cancer and he was more familiar with correcting a fistula in this area. At around 10:00pm the dr informed me that “I would have to have surgery to repair the recto-vaginal fistula, however, first I would require surgery to place a temporary colostomy bag to reroute my bowels, so the area in my uterine cavity could have a chance to heal enough so that the fistula could be repaired.” He stated,” the whole process would be 3-6 months, I would have the colostomy surgery, wait 3 months for it to completely heal then repair the fistula, wait another 3 months for that to heal and then take out the temporary colostomy. He recommended another dr., a general surgeon. My OBGYN came by and informed me that I had to drink some liquid in a green bottle to make my bowels begin move and to flush me out to prepare for surgery. I pumped my breast milk 2 times that day, but both times I was only able to pump a few cc’s of milk.

On Saturday, the new dr. performed the same exam, as my OBGYN had performed the previous day, this time it was even more painful. I thought I would climb off the table, it hurt so badly. The general surgeon came in and introduced himself to me, stating that “after we get your system flushed out he would schedule surgery to place the colostomy bag on my abdomen.” He explained that my uterine cavity had received so much trauma the past week that he would not consider placing the colostomy bag in that area, that he would place it above my belly button, on the right side. He stated, “You will have a scar about 3-4 inches long beside your belly button after the colostomy is removed.” At this time I asked him “to please not re-examine me a third time.” He stated, “You have had that done enough and I do not need to examine you at this time.” I asked him why he thought this had happened and he stated, “I don’t have the answers to those questions, and you will need to ask my OBGYN.” I then asked, “why him?” and his response, “because he would know since he delivered the baby.” At that point I told him that “Dr. delivered my baby.” He replied, “The person that delivered your baby has better answers than I do.” I asked the general surgeon to explain a little about my fistula repair surgery. He stated, “the cancer will have to cut you underneath your belly button down several inches to get into the area to repair the fistula, with it being such a large tear he may have to re-route your upper or lower bowel in order to repair the fistula.” So I am going to have three scars on my body that I had not planned on having. Sometime that day I was informed that I had to drink 4 liters of Golightly liquid in order to flush out my system, apparently the green bottle, from the previous day did not work. I was instructed to drink the 4 liters ASAP, per my oBGYN, My system finally began to flush itself out; I had fecal matter dripping out of my vagina as well as my rectum. Things got very messy from that point on. At one point I had an LPN tell me and my mother “You are not getting the adult diaper on correctly, you have to make sure it fits tight against the bend of your leg, so it does not leak and make a mess.” I replied, “I’m sorry this is my first day wearing diapers in a long time, I’m not real sure how they are supposed to go on.” At this point the LNP replied, “They go on just like a babies diaper, you know how they fit the baby.” Then my mother stated, “I’m sorry it has been about 33 years since I put diapers on her.” The LPN never offered to help us even though I was very shaky on my feet; I had not been able to eat anything since being admitted to the hospital. I also had a CNA lay an adult diaper on my bed and leave the room without helping me, after I had requested some assistance due to having has an accident, my sister assisted me with putting the diaper on that time. Thankfully I had a family member with me at all times, supposedly taking care of the baby, but most of the time I required their help with changing the diapers and getting in and out of the shower, due to lack of assistance from the staff that was supposed to be doing it.

It was on this day that I received a visit from my delivery doc. He arrived in my room and began talking with me; I was not sure who he was until he started discussing my patient history. I never had the opportunity to meet with him during my pregnancy, even though the doctors rotate in that particular practice, I had never met him until I delivered my son. I was pretty medicated at that time, so I did not remember what the doctor looked like, however, I recalled hearing his voice during labor.

After he arrived in my room to visit he began the exchange by stating, “I was not aware of your endometriosis surgery you received 2 years ago via laparoscopy, hindsight is 20/20, had I known I might have went straight for a C-section. The scar tissue from the endometriosis could have created a weak place in the bowel, depending on where the endometriosis was. I sutured the incision as far as I had cut, but there must have been a tear above the cut, if I had known about the possibility of a rip further up, I would have waited to sew you back up after the C-section.” (He had stated a few times while stitching up the episiotomy that he was having trouble due to the babies head being right there in the way.) He went on to say, “I don’t know why this happened, the baby’s head may have torn the bowel on the way down.” He again stated, “If I had thought there was a tear further up, I would have waited until the baby was out and lifted your uterus up and looked but I didn’t do that, because I was not aware of the tear.” We talked a few more minutes and I discussed my financial concerns with him, he stated, “don’t worry about the bill this will be covered by Medicaid. This is pregnancy related.” I asked him’ “why are you here on a Saturday? You aren’t on call this weekend.” I knew this because he was on call the previous weekend. He replied. “I have been thinking of you every day since I heard that you were re-admitted. I would have come to visit sooner, but I had a little cold and I did not share my germs with the baby.”

Later that day I was told that I would have my colostomy surgery the next day and was informed that I still had to drink as much of another 4 liter bottle of Golightly that I possibly could before midnight, afterwards I could have nothing. During the day and into the night I took several showers, to get cleaned up, my breast never leaked at all. I guess all of the antibiotics and medicine that had been pumped through my body caused my breast milk to dry up. I will not be able to breast feed my child as I had planned.

On Sunday one week after my child was delivered, the general surgeon performed the colostomy surgery. Again I was told to pump my breast milk and throw it away. I told the dr that “my milk was already dried up.” When I woke up from surgery in the recovery room I asked the guy in recovery, “Why does the outside of my right leg burn?” He stated, “Are you allergic to any type of adhesive, maybe you are having an allergic reaction to the tape.” I did not think anything about this again for a few days. After surgery I was moved to the sixth floor. All the nursing staff kept reminding me that it was a temporary thing. I did not want to hear any of this. I was not a happy camper at all. I kept thinking who goes into have a normal delivery only to come out with a colostomy and 2 more scheduled surgeries to maybe be okay?

On Monday I met the lady that instructed me on how to care for my colostomy. Again I was not in the mood to talk about and/or learn about a colostomy. She left me a video and instructed me on how and how often to change my bag. I spoke to her about my financial concerns and fears that Medicaid would not pay for hospital stay, I was overwhelmed by all the people who were getting involved in my care and all the people I would have follow-up appointments with and people providing me with services and supplies. She reassured me that everything will be fine and not to worry. She stated I would be sent home with 1 month supply of replacement bags and she would get me my needed supplies donated to get me through the 3 month period. She contacted one of Medicaid personal in the hospital about my concerns. The Medicaid representative contacted me via the phone and stated that my pregnancy Medicaid would expire on March 31, 2005, and it can not be extended, this hospital stay would possibly be covered if the proper paperwork was completed correctly, however, my next 2 surgeries would not be covered due to them being scheduled in 3-6 months from this surgery. The Medicaid representative told me that since the father of my child was involved in our lives that I do not qualify for any other Medicaid. I also do not qualify for disability Medicaid, unless I am disabled for over 1 year. This entire ordeal is/was very stressful for me.

On Wednesday I asked my OBGYN when I would be able to get released. He stated, “I want you to be on IV antibiotics for a few more days, to make sure all the infection is gone.” Afterwards the general surgeon came in to visit with me and I told him what ny OBGYN had said about a few more days of the antibiotics. He stated, “Yes, you need to be on antibiotics for 7-10 days after your blood shows positive for an infection.” This was the first I had heard that my blood was infected. I was not aware that I was that sick. Later that day the colostomy lady came in to check on me, during our meeting I remembered having the conversation with the gentleman in the recovery room after my surgery. At that time I looked at my leg and it had 2 bruises on it about 2 inches wide by 7 inches long with a space that was circular in shape down the middle. I could not figure out how I got this bruise. I asked her, she stated “that it was a burn from the cauterize form, it was placed on your leg during surgery to keep you from being shocked while in surgery.” Also during this meeting she stated that, “the general surgeon had shared with her that my uterine cavity was so infected and fecal material was so rampant when he performed my surgery that it was nearly impossible for him to be successful.” We talked about the previous conversations with both doctors earlier that day and she told that I had peritonitis and that I was septic when I was admitted, this was 1 day after the hospitial had discharged me stating I was fine. (I was not sure what that was but I get the impression it has something to do with e coli in my blood stream and the other places it is not suppose to be besides my rectum) and that I would need 7-10 days of antibiotics to recover. While we were talking about my illness she asked, “How exactly did you get so sick so quick? Were you discharged from the hospital?” I explained that I delivered my baby on Sunday and was discharged on Wednesday, only to return the next day to the ER with 102 fever. She stated, “Why did the doctor not know about the fistula, he was down there in the same vicinity/neighborhood, why didn’t he know.” I replied, “That’s kind of what I was wondering.” On this day for some reason it was difficult to receive formula for my baby, but the nurses did eventually bring the needed supplies. Sometime during my stay in the hospital my sister in law’s mother works in housekeeping on the 5th floor of this hospital, and the housekeeping staff said my case was the gossip of the hospital. She stated that everyone was talking about me and how the doctor messed me up during the delivery of my baby. She told my sister in law and my sister in law told me. That really makes me wonder who else was talking if housekeeping was.

On Thursday the delivery dr. came to do rounds today. He stated, “That due to the fistula being so big, (it was later found out to be 4 cm long, by another dr.) he felt that my prior endometriosis played a part in all of this. He wanted to discontinue my IV antibiotics switching me to pill form and discussed the possibility of me being discharged Friday, depending on how I well I could keep the medicine down. I told him that I wanted to continue with the IV antibiotics as long as I could due to what general surgeon had mentioned about staying on the meds for 7- 10 days. I told him that I had vomited the past 2 days and felt as if the IV meds were more tolerable. He stated, “He would order me a fruit tray at meals to help keep the medicine down.” I told him that the RN had already ordered me fruit trays at meal time. He informed me that he would be visiting with me every day and handling my discharge, due to my OBGYN being out of town. That day at lunch I received a regular tray and a fruit basket. The delivery dr. returned to my room and instructed me to let him know of any difficulties I had had with getting needed supplies for the baby. He stated, “I understand that yesterday there was a problem with getting what you needed, I have instructed the labor and delivery staff to bring you everything you need including diapers and wipes for your baby.” The nurses weighed me today and I have lost nearly 30 lbs since delivery.

On Friday, I was visited by the supervisor of labor and delivery. She stated, “I was unaware of your situation and I want you to know that if you need anything for the baby, just let me know and we will take care of it.” The delivery dr. asked if I was ready to be discharged, I told him that I would like to stay through the weekend, in order to get the IV antibiotics through Sunday. (Sunday would have been the 10th day on antibiotics.) My family had been taking turns taking off from work to stay with me throughout the past week. It was not as difficult for a family member to stay on weekends. My husband wanted to stay with me and our son; he had only been able to visit us for 2 hours per day, due to him having to work.

On Saturday delivery dr came in and stated, “I am discontinuing your IV antibiotics, I will come back this afternoon to see how you are handling the pill antibiotics.” I told him, “If that is the case than I want to go home today. I can take pills at home. I only wanted to stay until Sunday in order to get as many days of IV antibiotics as possible.” Delivery dr. said, “well I will go work on your discharge plans and come back to check on you, to see if you are able to keep the pills down.” My husband and I began to pack up everything. I was so excited to be getting to go home. When delivery dr. returned to my room to check on my status, he sat on my bed and began talking to me. He stated, “I know you are concerned about your lack of ability to pay for this and your upcoming surgeries, and Medicaid denying you, you do not need to worry about that at all. I do a lot of volunteer work with Outreach, a department within the hospital that deals with cases where people can not pay for there hospital stay, I am not even sure you OBGYN is aware of this services, anyway I am going to see to it personally that this and your next 2 surgeries and medical bills are taken care of, so don’t you worry at all. I’ll talk to her and we will get it taken care of.” I was discharged at around 12:00pm.

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i have an RVF that's the result of a cryptoglandular abscess...basically, i had an anal abscess that tracked backwards into my vagina. this started over 2 years ago...since the abscess was in my vagina, i went to my GYN...i was diagnosed with have a Bartholin's gland cyst...it kept recurring, and there was constant drainage of abscess material (or so i thought). i had several surgeries, and an MRI to see if i had a fistula, and no one could find anything. finally, in august of 2007, a colorectal surgeon found a small fistula. he placed a seton, and then i had a plug repair in December. the plug fell out within 5 days, so no i'm back to having another seton placed next week.

so yes, i have an RVF that is not related to obstetric trauma. i've never been pregnant.

i also have a question...
i have extraordinary pain, most of the time. it's gotten worse since my plug procedure. my doctor basically told me that he doesn't believe me, that he's never had a patient with as much pain as i have...does anyone else have constant, sometimes debilitating pain? what helps (besides sitz baths)?

lauren




jaidynsmom wrote:

I would like to know if anyone has gotten an RVF that was not due to the vaginal delivery of a child?

I was diagnosed w/a perirectal abscess in June '06 and I was told that a RVF was possible after my surgery to remove the abscess. And as it usually is for me, if there can be a problem, there will be. As I was being admitted to the hospital for the abscess surgery, the abscess ruptured in my vagina. I was told by my surgeon that this would heal by itself as would the two other holes that he cut to drain the abscess. Well needless to say a fistula has now developed. I am having gas and stool pass through my vagina.

With all of the posts, I am beginning to think that my chances for 100% repair are pretty slim.

Any suggestions on which would be the best possible repair?

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If you need to talk:
****
I know what you are going through...


Guest wrote:

I know my story is like most on here,,,but i just really need someone to talk to about all of this
Well, I had my daughter back in 2004...well i ended up having a 4th degree tear with my episiotomy.
Well after i had gone for my 6 week check up,,,they said it healed up nicely...well im not sure how long after that ,,that i realized that there was stool coming out of the wrong place...at first i thought it was that brownish blood kinda spotting between periods,,,but soon realized it wasn't....and also noticed that gas would come through too.
Well i mentioned it to my ob/gyn (not the one the delivered her) and she said yeah that happens sometimes,,,but just excersize and eat good...
so i was like ok,,,i guess i just have to deal with this. It didnt hurt like others stories i have read ,,it is just the passing of stool and gas.
Sorry this is so long,,,well just this year i switched ob/gyns and i mentioned this to him,,,and he said that he did notice what he thought may be stool in the vagina,,,and quickly refered me to a colorectal surgeon.
Well i ended up going and he did an exam in the office trying to see if he could feel it,,,he couldn't , but said that the wall between the two was very thin.
So he set me up to have a Flex Seg...its like a partcial colonoscopy,,,,,this app was with his wife who is also in practice with him....she said she didnt see anything,,and that it looked normal....well they had scheduled some Contrast Enema thing but needed to do a colon cleanse the day before....well after the flex seg i didnt really feel like she talked with me very much to inform me of what was going on,,and help inform me of what this other test was,,so i ended up canceling the app,,,and made an app to talk to her first.
So i took my mom with me to talk to her on thursday,,,and she said she thinks i just need to do this high fiber diet and wear a tampon for a while to see if i can see on there where it is coming through...she seems to think that i "think" it is coming out of my vagina and really isnt,, it may just be "smeary" and getting everywhere,,,and as far as the gas it could be caused from the thin wall or area between the two,,it may make it feel like a vibration...
So at first i was like ok,,,that sounds good,,,hopefully this fiber works....but as i think more about it and really pay attention,,,,,there is no way there is not an opening somewhere in there,,,,and i persoanly think it is very very low just above the surface,,and i think they were just looking too high for it,,,or maybe it is only visible with pressure...
Well anyway,,i just wanted to talk to someone who maybe has delt with this,,and could i be wrong about the fistula? could the dr. be right? it just seems really unlikly having delt with this for 4 years,,i think i would know.
well any help you could give would be greatly appreciated.!
And also what kind of tests or exams were done to determine if and where exactly your fistula was? Im just feeling like the dr. thinks im stupid and i dont know what im talking about cause im only 23,,,,i just know this is not normal.



**edited by moderator**

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Wow, I am glad that I found this.
I to have been dealing with a recurring recto vaginal fistula that I have had for the last 10 1/2 years. It started with the birth of my first son. I swelled up very badly after they had to use the forceps to remove him, so when she was sewing me up apparently she had a hard time. (I know this because when I got up to the recovery room all of the nurses were saying, "You're the one that swelled up so bad." I didn't really notice at first that something was wrong, I had a bartholin's glad cyst that had been draining constantly for about 2 to 3 years prior to giving birth and stopped during the last trimester, so I just thought that was happening again, well it wasn't.

I always would have some discharge, but was informed that it was just a bacterial infection and giving antibiotics. I did not know that it was actually an RVF until my son was about 3. I moved to a new state, got married, and started seeing a wonderful OBGYN that diagnosed me. He told me that if it wasn't bothering me, I could leave it alone, or I could have reconstrucive surgery. I opted to leave it alone, since I wanted to have other children and a vaginal delivery, until Sept. 2001 when it really started hurting. I then scheduled surgery with my OBGYN. I went though the normal pre op stuff, golightly and antibiotics that made me so sick that the night before I had dry heaves so bad the doctor had to call me in a prescription for Phenergan and the nurses had a hard time giving me an IV the next day.
After the surgery I was in a great deal of pain. I had asked if I needed antibiotics for more than the 1 day that I was in the hospital (post op) and was told no. Well the repair seemed to have worked, but the pain got worse. I called the office and was told to take the sitz baths more often. After 4 days the pain became unbearable and I started to pass gas again as I did with the RVF. Well I went in and found out that I had an infection prior to the surgery (due to the type that it was) that had gotten into the incision when they operated. So this surgery failed.

Three months after the first surgery I found out that I was pregnant with my second child. My OBGYN and I talked about the RVF and the possibility of repairing it when my second child was born. At the last visit prior to the birth, the doctor evaluated me and decided that it was best to not attempt to fix the RVF due to the possible blood loss that could occur (I had some very large protruding veins that he was concerned about). Well, the baby had other plans. My son was 9 lbs 6 1/2 oz. I was cut for the episiotmy, but ripped right into the fistula. The doctor spent an hour and a half after the baby was born attempting to fix the fistula. He gave the nurses strict instructions on my medication as far as stool softeners and other things, which were not followed. The repair only lasted 2 days that time before the fistula reocurred.

I then decided to wait again. I did not want it to fail again. I was having problems in my marriage by this point. The emotional stress of that plus my body not being right was horrible. My husband called me "rotten crotch" and other things relating to my RVF when he got mad at me. There was nothing that I could do. I kept wishing that I could just have the surgery again and that it would work.

I spoke to my OBGYN again about this. He did not want to attempt another repair himself, but wanted to refer me to another doctor that was a GYN that specialized in cancer. So, I went to meet him. He seemed very nice. He stated that he would do the same type of repair as the first repair attempt, total reconstruction. Which we did. This time I was confined to the bed for 24hours of lying down after surgery. I had liquids for 2 days, and at my first bowl movement, I noticed the surgery had not worked. I feel that this was from the doctors lack of planning. He found one hole and fixed it, not realizing that the fistula can track through with many different openings on both sides (it is not just a one way in an out deal).

At this my husband said "I told you so" as he never beleived that it would work. Just what I needed at the time, another failed surgery and an uncaring husband.

My husband and I got a divorce last year :-D

I met a great new guy that I began dating, and it was so hard to tell him what happened, but you have to. Somehow passing stool and gas through your vaginal opening is something that you just can't keep hidden. I thought that would scare him away, but it didn't. So, last March my OBGYN and I had a discussion again. He told me that he would make some calls and see if he could find another surgeon that could help. He gave me the name of a doctor in a town 2 hours away (I would go a world away if this would just be gone). I met with the doctor and really liked him. He explained that I would have to have another reconstruction, that the surgery would take about 4 hours as he would make sure that he tracked down and repaired every tract of the RVF and that I would be in the hospital post op for about 5 days. So I planned the surgery for July 07 and started the planning, well I still have not had that surgery. In the mean time I ended up with a broken disc in my back and had back surgery in July. Got married again in October and here we are in January.

I know that lots of you have dealt with more and longer problems than I. I just wish that there was a guarantee that the surgery would work if I have it again. My new husband and I want to have baby together within the next years, but if I have the RVF repaired before then, I will have to have a C section. I am 33 years old at this point and feel that I will always have this problem.

Does anyone know of a really good surgeon to repair this. At this point, I am willing to go to almost the ends of the earth to find someone that has repaired many of these sucessfully. PLEASE...if you know one. Let me know.

I don't think that anyone should have to deal with the kind of personal pain both physically and emotionally that this type of aflection puts us though.

May GOD bless all of you and help you through your struggles with RVF and all of life.

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