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Hi I had a rectovaginal fistula earlier this year following an episiotomy and then 4th degree tear during birth of my first baby! I am passing gas and stool via vagina. I have read some of the previous discussions on this topic. In most cases, sounds like surgery or rather numerous surgeries have been needed with variable success. I am keen to avoid surgery so would like to hear if anyone has been fortunate enough toheal without surgery or to recover after just 1 surgery? Thank you in advance! This whole experience is driving me crazy!

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A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina.

Rectovaginal fistula may be extremely debilitating. If the opening between the rectum and vagina is wide it will allow both flatulence and feces to escape through the vagina, leading to fecal incontinence. There is an association with recurrent urinary and vaginal infections. Due to constant infections that can occur, it is not recommended that a woman allow the area to heal on its own - and in most cases it will not, especially with the severity that you are describing. Does anyone have any other methods of repair besides surgery? I will be looking into this a little further as well. Please check back.
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Thanks for your reply. My symptoms are variable right now with some days with stool passing through, and fortunately when it does, it is usually a small amount following a BM. Gas is usually only noticeable to me or my husband though somedays it is worse. No signs of infection yet. So that's why I was curious to see if it might heal by it self. My colo-rectal surgeon is monitoring things.
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Hi..just checking to see if there was anyone that had self healed? Thanks
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Hi Upset1, I understand your hesitance to get surgery. Surgery can be complicated, difficult, and scary, I'm sure! But I do know that fewer than 20% of fistulas actually heal on their own. How long have you been dealing with it? Do you think you could explain a little more why you are trying to avoid surgery? I am curious to know only because it seems like your issue would be cleared up quicker by this point if you do go through surgery instead. I am glad to hear that your surgeon is keeping track of the situation as well. I hope to hear back from you!
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Hi,

Let me first say that my fistula apparently did heal on it's own....
It is so hard to find information or people to share this experience with!
I am glad to have finally found recent posts on this subject. I had my son nearly 2 years ago; I am pregnant again (due in August) and am having am having cold feet about a suggested C-section (but I really do not wish to "open up" the fistula again or make it worse)..

anyways, my story:
I was trying to go all natural, but asked for an epidural about 10 hours in, 5cm dilated...they gave me too much; I felt it almost up to my collar bone! I pushed for nearly 2 hours, and was told that I'd need an episiotomy-- at this point I just wanted my baby out! It was the on call Dr. that I'd never met that delivered me and sewed me up....I remember hearing the words "3rd degree laceration". I was in the hospital 4 nights total (passed out twice, so they kept me longer than usual, and then my son needed phototherapy for jaundice). My regular OB visited me a couple of times, but NOBODY every checked my stiches nor were sitz baths suggested (maybe they thought I should know to request one?!).

Once home, nearly 2 weeks after delivery, I felt something was wrong-- I was experiencing a burning/pulling sensation in the vaginal area...wasn't sure if this was normal, but I have an older sister who had a 4th degree laceration, and said that she had felt pretty healed by 2 weeks postpartum. Soon after I noticed gas passing through the vaginal area, and soon after that feces...freaked me out. I did some online research, found the terminology for what I was experiencing, and called my OB--
As luck with have it he was away at a conference. Still, he was able to prescribe me some Premarin-- an estrogen cream. I read the labels-- said not to use while breastfeeding, but he said that if I used it just topically it would be ok. So, I did.

Went to the ER just in case...which was pointless....I was told if I had a fistula I would need to wait and let it heal awhile first anyway.

I saw my OB when he was back from the conference. After a very painful exam, he confirmed an RVF, and tole me to keep using the Premarin and wait some more. At my 6 week appt., the fistula was still evident...though the exam was not quite as painful (evidence of healing?). Again he told me to wait and come back when/if I felt I needed to. He was talking about referring me to a surgeon friend of his that he played golf with.

I decided finally to have my primary care physician refer me to a specialist. She did; I went to a Colo-Rectal Specialist at UCLA medical center...this was 5 months post delivery. He could not see the fistula (and I had stopped having the feces symptoms by this time), but did find granulation and told me to continue to abstain from sex or tampon use for at least another month. He said that there were options to see if the fistula was still there (it possibly shrunk to a microscopic level); however, he said that if it was now just a very small fistula it may be more risky to do surgery than not....and left any decisions re: more tests up to me. He informed me that I also had a very weak anal sphincter, and was the first to tell me that with future pregnancies I might want to seriously consider a C-section.

I still seem to have a gas issue, but I can control it now...per the UCLA specialist some of the gas issue could be related to other anatomical changes...like a pocket that has developed.

Sorry for the terribly lonnnnnnnng arsch email! I just wanted to share my story...

Why my fistula healed I don't know...I have read differing opinions on breastfeeding: the one about it weakening the pelvic wall, but I recently read one Dr.'s reply to another online that said nursing may actually help with the healing. I can tell you what I did (but I'm sure many other women did the same):

1) It was a small fistula to begin with
2) Once I discovered the fistula I either sat in a bath or squirted out the area (with a handheld shower) after every bowel movement
3) I used Premarin topically
4) I breastfed exclusively for 6 months, and then with formula supplementation through 8 months

I can't tell you when, exactly, it closed up, but I did go back to work when my son was 3 months old...by that time I was still having gas issues, but the feces had stopped coming through.

again, sorry so long, but I'm glad to be able to share my story...
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I'm amazed to read stories of similar experiences to my own. I had a 4th degree episiotomy and told my doctor numerous times before that I never wanted one! I didn't know how bad the laceration was until a day later when the nurse told me. After going home and having a BM, I thought I was in labor all over again. That's when I noticed passing feces through the vagina. I called my OB immediately and she told me it would take 6 months before the colorectal surgeon would perform surgery. After waiting a gruling 6 months I had the procedure performed and have never been the same. Of course there is nothing passing via the vagina that shouldn't be, but controling gas or loose stool is another subject entirely! A woman in her 30's is too young to have these medical issues. I was wondering if any of you have strengthened your muscles and just how did you do it? Kegels are not doing it for me.
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Hi, this topic has been inactive for a while but I'm wondering if the original poster was able to have your fistula heal on its own? I'm experiencing a somewhat similar situation but my surgeon wants to wait for it to heal on its own.
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lou914 wrote:

Hi, this topic has been inactive for a while but I'm wondering if the original poster was able to have your fistula heal on its own? I'm experiencing a somewhat similar situation but my surgeon wants to wait for it to heal on its own.



I am 3 weeks post-surgery and so far everything is going well. Just wanted to give a big cyber-hug to all who are going through this...it's not easy.

For Lou914, I was followed by a colo-rectal surgeon for 3 months before deciding on surgery -- it's better to try to wait it out and see if it will heal on it's own. I had my surgery at 4 months post-birth; however, many women wait until 6 months. For me, the RVF was giant to begin with and it had been 8 weeks since there was any reduction in size, so I didn't want to wait and there was no medical reason to delay the surgery.

Good luck!
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I there, i too had a rectro vaginal fistula!! Please join our private group on facebook, there are about 20 of us now around the world. we are like sisters and are supporting eachother through every step of the way! Its called "living with a obstetric fistula"

 

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Thanks so much for this account. It gives me hope. Mine is so small it doesn't show up on a colon xray with CT contrast. My doctor says that's an indication that it is healing on its own. I really hope it is. I cant go through another surgery
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Yasmin72 wrote:

Thanks so much for this account. It gives me hope. Mine is so small it doesn't show up on a colon xray with CT contrast. My doctor says that's an indication that it is healing on its own. I really hope it is. I cant go through another surgery


Thanks for this forum, I learned a lot reading through the replies and on different sites online too. This is one of my question too: "Can a recto-vaginal fistula heals by itself?

I had in Sept last year an hysterectomy and in June a bowel resection done. Got out in record time and was feeling great. Unfortunately, I started to have pain 2 weeks after and I had pus and disgusting smelly stuff coming out of the vagina and then feces followed. Got scared, called my family doctor and the surgeon who did the procedure. My surgeon asked me to come to see him and after a rectal exam, told me I had an abscess that created a recto-vaginal fistula. A case of bad luck he said. Re-admission to the hospital the next day with CT scan that confirmed an abscess 5 cm and a recto-vaginal fistula. Antibiotics in IV for 9 days. Go released with no more stools coming out, just drainage of the abscess which is now 2.5 cm. Excellent, I want to get out of there and start recovery. Got one month of Ciprofloxacin and Metronidazole.

I started to get much better (when he took me off the antibiotics) until I expelled vaginally 6 days after seeing him, a surgical clip wrapped in what seems to be black tissue and a round rubbish yellow thing. Took pictures, sent them to the surgeon and put everything in alcohol. Within an hour, another bowel movement, and then stools are coming out again. Just lovely! My family doctor saw me and told me to go to ER if I get worst and can handle fever or pain. Same antibiotics prescribed for another month. Saw the surgeon only 3 weeks later (he was on vacation) and he told me that this was indeed a clip used to block the blood vessels when they do surgery. "It can stay in, it's in titanium". Wow, how come I got it that way? "Well, it felt, things like this happened" he said. He ordered, a colonoscopy, pelvic exam and CT scan again.

Saw him last week; good news. The abscess is gone so no more antibiotics. One thing, he cannot find the fistula anymore. The colonoscopy showed inflammation in the area so he couldn't see the fistula. When he did the pelvic exam after the colonoscopy while I was under sedation (I felt it and did remember it), he couldn't see it there either. I knew it was still there, I had a bit of stools half an hour before seeing him when I rushed to the washrooms with diarrhea. He ordered another CT scan and I should know tomorrow what's going on. I didn't get any discharge for 4 days now, it feels good not to wear pads for a while. Maybe it's actually healing by itself which I hope so although I'm not putting my hopes too high since I just read that only 20% of fistulas do heal without surgery.

If I need a surgery, I will be referred to another surgeon, that's the good news. I might have a better and more scientific explanation than bad luck and things happened which is getting me frustrated big time. I noticed that I still have the PMS symptoms; you know the one that grows our teeth long enough to scratch the ground?

Sending positive thinking to all of you.

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I have not had a baby, but had rectal cancer and took chemo and radiation. I had one surgery to remove the area. Three months later I had a surgery to close the ileostomy that they gave me while I healed from the first surgery. Two week after that I was passing stool thru the vaginal area and went to ER and found out I had a rectovaginal fistula. To remedy this, my surgeon put in a fistula plug over 6 weeks ago. This didn't work. Tomorrow I'm scheduled to have another plug put in. If this doesn't work, I'm told I may need to have a permanent colostomy. I DO NOT WANT ONE OF THOSE! I'm looking into some clinical trials to see what is out there. A university in Spain is using stem cells from your own body to treat this. They will only take spanish people in this study, but the group will treat others (not part of the study) if you fly to Madrid to have it done. Surely there must be some other clinical trials in the U.S. The one that Spain is doing intrigues me. I'm praying for this fistula plug to be successful. A natural healing would be wonderful. I'm still praying for that also.
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Hello, 

Im sooo glad I found this site as I am too suffering from something like this!!

I had my son 10 months ago I had a natural birth but had a nasty 4th degree tear. A few weeks after I noticed pulling down feeling and I was passing gas through my vagina but as this was my first baby I thought it was normal. When I had my 6 week post partum exam with a doctor he examined me and took a sample. I came back a few weeks later after having pains and found out this particular doctor had the cheek to send of my sample and had it tested for a gnorreah!!!!!!!! I was outraged!!! lucky enough i had a nice locum doctor who examined me and told me I had a urine infection and sent of another sample to a lab and she told me she would refer me to another post partum doctor. I had my appointment and after a very painful exam the doctor said she would refer me to a urigynea as she noticed a unusual discharge. I finally had my urigynea 2 weeks ago! after 2 more bouts of UTIs and waiting ages. This doctor said I was healing nicely but wanted to send me for a perineal scan. I saw this doctor lastweek and he told me I might have a RVF and I am very scared indeed esp since he mention a MRI and surgery :((((( I really dont want to go thought 6 months of healing like I did after giving birth and I am very keen to not have surgery. I really think there should be more support for women with RVF and information.

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Hello, I've been too embarrassed to tell anyone until seeing these posts, but since having a TVT mesh implanted for stress incontinence I have suffered really bad complications which I won't go into to. The thing is, also since having the TVT I have been passing gas through my vagina, it is so embarrassing I have not even told my doctor and sometimes I will be speaking to someone at work etc and this will happen making a noise. I could curl up and die! I don't pass stools through my vagina but now when I pass a stool I also pass urine at the same time, which I did not previously. I wandered if anyone else has experienced this please?

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