Materiały źródłowe

• #1 Rectovaginal Fistula: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22260-rectovaginal-fistula

  Rectovaginal fistulas, or holes, develop between your vagina and rectum. Vaginal tears in childbirth, as well as pelvic surgeries, can cause this type of vaginal fistula. […] Trauma to vaginal tissue stops blood flow, causing the tissue to die and creating a fistula. Rectovaginal fistulas can develop in a matter of days. Or they may form over several years. A person rarely has a congenital rectovaginal fistula, which means the opening is present at birth. […] Causes of rectovaginal fistulas include: Prolonged labor, vaginal tears during childbirth or if your healthcare provider made a cut (incision) to help you deliver your baby (episiotomy). Abdominal or pelvic surgery, including C-section and hysterectomy. Cancer in your pelvic area, such as cervical cancer or colorectal (colon) cancer. Inflammatory bowel diseases (IBD) like Crohns disease and ulcerative colitis. Colon infections like diverticulitis. Radiation therapy to your pelvic region. […] Women who have prolonged labors or undergo pelvic surgery are more likely to develop rectovaginal fistulas. These openings form between your vagina and rectum, allowing gas and stool to leak out through your vagina.

• #2 Rectovaginal Fistula | Intimate Wellness Institute

  https://iwiva.com/home-page/womens-speciality-care/urogynecology/bowel-issues/rectovaginal-fistula/

  A rectovaginal fistula is a tunnel-like opening that develops between your vagina and rectum. […] In a rectovaginal fistula, damage to vaginal tissue causes the tissue to tear or die and a hole (fistula) to form. […] Trauma to vaginal tissue or pressure to the tissue that stops blood flow, causing the tissue to die and creating a fistula are by far the most common causes. Rectovaginal fistulas can develop in a matter of days or they may form over several years. […] Causes of rectovaginal fistulas include: Prolonged labor, vaginal tears during childbirth or if your healthcare provider made a cut (incision) to help you deliver your baby (episiotomy). […] Abdominal or pelvic surgery, including C-section and hysterectomy. […] Cancer in your pelvic area, such as cervical cancer or colorectal (colon) cancer. […] Inflammatory bowel diseases (IBD) like Crohns disease and ulcerative colitis. […] Colon infections like diverticulitis. […] Radiation therapy to your pelvic region.

• #3 Rectovaginal fistula – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rectovaginal-fistula/symptoms-causes/syc-20377108

  A rectovaginal fistula may result from: […] A rectovaginal fistula may form as a result of: […] Injuries during childbirth. Delivery-related injuries are the most common cause of rectovaginal fistulas. […] Inflammatory bowel disease. The second most common cause of rectovaginal fistulas is Crohn’s disease and, more rarely, ulcerative colitis. […] Cancer or radiation treatment in the pelvic area. A cancerous tumor in your rectum, cervix, vagina, uterus or anal canal can result in a rectovaginal fistula. […] Surgery involving the vagina, perineum, rectum or anus. In rare cases, prior surgery in your lower pelvic area, such as removing an infected Bartholin’s gland, can cause a fistula to develop. […] Complication from diverticulitis. Infection of small, bulging pouches in your digestive tract, called diverticulitis, may cause the rectum or large intestine to stick to the vagina and may lead to a fistula. […] Other causes. Rarely, a rectovaginal fistula may develop following infections in the skin around the anus or vagina.

• #4 Rectovaginal Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535350/

  RVF formation results as a complication of an underlying disease, injury, or surgical event. Diseases of the vagina or the pelvic organs can be complicated with a persistent connection between the rectum and vagina. The common causes of rectovaginal fistula are: […] Obstetric-related injury: This is the most common etiology of traumatic RVF, and probably for all RVFs. This includes third- and fourth-degree lacerations during vaginal delivery. […] Surgical procedure: Surgical interventions that cause unrecognized vaginal or rectal injury, insufficient tissue thickness between the two organs, or ischemia of the tissue may result in perforation and fistula formation through the damaged tissue. […] Diverticular disease: Complex diverticular disease is a common cause of fistula connecting to an intra-abdominal organ like the bladder and vagina. Erosion of the diverticular wall with inflammation and abscess can extend, involve, and erode the adjacent organ walls resulting in a fistulous connection.

• #5 Rectovaginal Fistula – Your Pelvic Floor

  https://www.yourpelvicfloor.org/conditions/rectovaginal-fistula/

  The majority of rectovaginal fistulas are caused by childbirth injury. Trauma related to operative vaginal deliveries such as forceps and vacuum deliveries, as well as third- and fourth-degree tears, increases the risk for rectovaginal fistulas to develop. Rectovaginal fistulas can also develop following radiation to the pelvis or in women with inflammatory bowel disease. There are rare cases of congenital rectovaginal fistulas. […] Risk factors for development of rectovaginal fistula include: Obstetric trauma Inflammatory bowel disease, Gynecologic or colorectal surgery, Perianal infections, Radiation to pelvis, Malignancy, Violent trauma, Congenital anorectal anomalies.

• #6 Rectovaginal and anovaginal fistulas – UpToDate

  https://www.uptodate.com/contents/rectovaginal-and-anovaginal-fistulas/print

  Anovaginal fistulas (AVFs) and rectovaginal fistulas (RVFs) most frequently result from obstetric trauma, especially in resource-limited countries where prolonged obstructed labor can lead to pressure necrosis of the rectovaginal septum. […] These fistulas can also occur following a failed repair of a third- or fourth-degree laceration of the perineum, from unrecognized injury at the time of vaginal delivery, and from episiotomy infection. […] Radiation damage and Crohn disease are two other important causes of RVFs. […] RVFs may also occur following difficult hysterectomies, especially those performed for severe endometriosis with involvement or obliteration of the posterior cul-de-sac (pouch of Douglas); from extension or rupture of perirectal, perianal, and, rarely, Bartholin’s abscesses; and from any surgical procedures involving the posterior vaginal wall, perineum, anus, or rectum. […] In older women, RVFs can occur as a result of diverticulitis, colon cancer, or fecal impaction. […] In addition, treatment options for pelvic organ prolapse such as pessaries and various mesh repair procedures have been associated with RVFs.

• #7 Evidence – Rectovaginal fistula: Anterior levatorplasty and external sphincter plication

  https://www.webop.com/general-and-visceral-surgery/Proctology/rectovaginal-fistula-anterior-levatorplasty-and-external-sphincter-plication/evidence

  Rectovaginal fistulas make up about 5% of all anal fistulas. The overwhelming majority (88%) is due to delivery trauma and affects 0.1% of all vaginal deliveries. Further causes are chronic inflammatory bowel diseases (especially Crohn disease) with up to 2.1% and deep anterior resections with up to 10%. Rectovaginal fistulas are increasingly encountered as complications in hemorrhoidal surgery and functional pelvic floor disorders, particularly where staplers or foreign body materials are concerned. […] While most rectovaginal fistulas are traumatic in origin, other causes include inflammatory processes and postoperative complications after pelvic surgery. […] 88% of all rectovaginal fistulas are caused by traumatic vaginal dilatation with tearing of the perineum and rectovaginal septum.

• #8 Rectovaginal fistula – Wikipedia

  https://en.wikipedia.org/wiki/Rectovaginal_fistula

  Rectovaginal fistulas are often the result of trauma during childbirth (in which case it is known as obstetric fistula), with increased risk associated with significant lacerations or interventions are used such as episiotomy or operative (forceps/vacuum extraction) deliveries […] Rectovaginal fistula is said to be known as the leading cause in maternal death in developing countries. […] Fistulas can also develop as a result of physical trauma to either the vagina or anus, including from rape. […] Rectovaginal fistula can also be a symptom of various diseases, including infection by lymphogranuloma venereum, or the unintended result of surgery, such as episiotomy or sex reassignment surgery.

• #9 Rectovaginal Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535350/

  Crohn’s disease: Chronic inflammatory bowel diseases, especially Crohn’s disease, is a well-known cause of intestinal fistulization. Crohns is a transmural disease that involves the entire thickness of the bowl, making an extension to and involvement of adjacent tissues and organs very common. […] Malignancy: Cancer of the intestine or adjacent organs is a known cause of bowel perforation and fistulization. RVF can result from vaginal, cervical, or, more commonly, rectal cancer that involves the entire wall thickness and extends to the adjacent vagina. These fistulae are also called malignant fistulae. […] Radiation: Radiation causes long-term chronic tissue inflammation with poor healing and repair processes. Therefore, fistulae caused by radiation manifest after a lag period from radiation exposure.

• #10 Minimally invasive endoscopic repair of rectovaginal fistula

  https://www.wjgnet.com/1948-9366/full/v14/i9/1049.htm

  Rectovaginal fistula (RVF), a type of chronic gastrointestinal fistula, refers to an abnormal epithelialized-lined connection between the rectum and the vagina, presenting with symptoms including uncontrollable passage of gas and/or fecal discharge from the vagina. […] Obstetric trauma is the primary etiological factor for RVF, but it can also be acquired from local abscess, pelvic floor or rectal surgery, trauma, or radiotherapy. […] Chronic inflammatory bowel disease (most commonly Crohn’s disease) is the second most common etiology with rates varying between 6% and 23%. […] It is reported that RVF occurs in up to 10% of women diagnosed with Crohn’s disease. […] Congenital RVF is rare, usually coexists with anal malformation, and can be treated by anal reconstruction at a young age.

• #11 Rectovaginal Fistulas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2967329/

  Inflammatory bowel disease is another possible culprit. Both ulcerative colitis and Crohn disease can be associated with rectovaginal fistula. […] Other rare causes of fistulas have been reported, including fecal impaction, vaginal dilatation after radiation to the vaginal cuff, viral and bacterial infections in patients with human immunodeficiency virus (HIV), and sexual assault.

• #12 Rectovaginal fistula – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/rectovaginal-fistula/

  A rectovaginal fistula may result from: […] A rectovaginal fistula may form as a result of: […] Injuries during childbirth. Delivery-related injuries are the most common cause of rectovaginal fistulas. This includes tears in the perineum that extend to the bowel, or an infection of an episiotomy — a surgical incision to enlarge the perineum during vaginal delivery. These may happen following a long, difficult, or obstructed labor. […] Crohn’s disease. The second most common cause of rectovaginal fistulas, Crohn’s disease is an inflammatory bowel disease in which the digestive tract lining is inflamed. Most women with Crohn’s disease never develop a rectovaginal fistula, but having Crohn’s disease does increase your risk of the condition. […] Cancer or radiation treatment in your pelvic area. A cancerous tumor in your rectum, cervix, vagina, uterus or anal canal can result in a rectovaginal fistula. Radiation therapy for cancers in these areas can also put you at risk. A fistula caused by radiation usually forms within six months to two years after treatment.

• #13 Vaginal fistula – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vaginal-fistulas/symptoms-causes/syc-20355762

  Certain cancers and radiation therapy. Cancer of the anus, rectum, vagina or cervix can lead to a vaginal fistula. So can damage from radiation therapy for the treatment of cancer in the pelvic area. […] Diverticulitis. This condition involves small, bulging pouches in the digestive tract. Diverticulitis that leads to a vaginal fistula is more common in older people. […] A large amount of stool stuck in the rectum. This condition is known as a fecal impaction. It also is more likely to cause a vaginal fistula in an older person.

• #14 :: astr.or.kr :: Annals of Surgical Treatment and Research

  https://astr.or.kr/DOIx.php?id=10.4174/astr.2019.97.3.149

  Rectovaginal fistula can result from various causes and diverse surgical procedures have developed as a result. […] The most common cause was radiation therapy, followed by pelvic operation, birth injury, perineal operation, cancer invasion, and trauma. […] Radiation therapy and pelvic operation as cause of fistula were significantly poor prognostic factors (P = 0.010, P = 0.045) and Crohn disease had a tendency for poor prognostic factors (P = 0.058). […] The purpose of this study was to investigate the outcome of surgical treatments for RVF according to the various causes and procedures and to analyze the prognostic factors for successful RVF closure. […] The most common cause of fistula was radiation therapy (RT) for cancer (n = 27 [29.3%]). […] Pelvic operation with rectal resection can lead to iatrogenic injury of the rectovaginal septum due to the double-stapling technique, or develop postoperative leakage at the anastomosis site.

• #15 Evidence – Rectovaginal fistula: Anterior levatorplasty and external sphincter plication

  https://www.webop.com/general-and-visceral-surgery/Proctology/rectovaginal-fistula-anterior-levatorplasty-and-external-sphincter-plication/evidence

  1% to 2% of all higher-grade perineal tears, dehiscence of the primary repair and inadequate care results in rectovaginal fistula. […] Rectovaginal fistulas through local infections arise especially from cryptoglandular infections and bartholinitis. […] Rectovaginal fistulas after rectum resection are caused by iatrogenic perforation of the vagina and the use of staplers. […] Most important risk factor: Use of staplers, e.g. accidental involvement of the vaginal wall after previous hysterectomy. […] Rectovaginal fistulas after other rectal operations and procedures in the lesser pelvis include transanal tumor ablation, stapled hemorrhoidectomy, and surgery for pelvic floor dysfunction with staplers or mesh implants.

• #16 Rectovaginal Fistulas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2967329/

  Rectovaginal fistulas may be caused by childbirth. Prolonged labor with necrosis of the rectovaginal septum or obstetric injury with a third- or fourth-degree perineal tear or episiotomy can lead to rectovaginal fistula. […] Infectious processes within the rectovaginal septum can also result in a rectovaginal fistula. Cryptoglandular anorectal abscesses and Bartholin gland infections may spontaneously drain causing a low rectovaginal fistula. […] Malignancies may cause rectovaginal fistulas. These are usually seen in the setting of rectal, uterine, cervical, or vaginal malignancies that have significant local extension or have been treated with radiation therapy. […] Operative trauma can result in rectovaginal fistula. Low fistulas may be the result of anorectal and vaginal operations.

• #17 GMS | GMS German Medical Science — an Interdisciplinary Journal | German S3-Guideline: Rectovaginal fistula

  https://www.egms.de/en/journals/gms/2012-10/000166.shtml

  Rectovaginal fistulas may also be caused by local infections, particularly cryptoglandular infections and Bartholin gland abscesses. […] In addition to the potential injury to the vagina during preparation, the use of staplers represents a risk factor for the development of rectovaginal fistulas secondary to rectal surgery with or without pouch creation. […] Some case reports have been published on fistulas secondary to radiotherapy. […] Direct invasion of the respective other organ (e.g., the rectum in case of gynecological malignancies or the vagina in case of anal or rectal carcinoma) can cause fistulas as well.

• #18 Rectovaginal Fistula: Causes, Symptoms And Treatment

  https://www.netmeds.com/health-library/post/rectovaginal-fistula-causes-symptoms-and-treatment?srsltid=AfmBOophkNb3pkDcNpWA_5woKDfsoY-FhKMOUOl4FgHRU5nI386HB2CG

  Radiation to the pelvic region: Exposure to radiation therapy for treating cancer in the vagina, uterus, cervix, rectum, or anus can often cause a rectovaginal fistula. Even cancer of the above parts without radiation can also create a fistula. Surgery: A surgical procedure on the rectum, vagina, perineum, or anus can result in an injury or infection that leads to an abnormal opening or fistula. […] Other probable causes of Rectovaginal fistula include: An infection in the anus or rectum, Infected small pouches in the intestines (i.e., diverticulitis), Blockage in the rectum due to accumulation of stool (i.e., faecal impaction), Infections due to HIV or AIDS, Sexual assault causing vaginal injury.

• #19 Rectovaginal Fistula (RVF) | Loma Linda University Health

  https://lluh.org/conditions/rectovaginal-fistula-rvf

  A rectovaginal fistula (RVF) is an abnormal connection between the rectum and vagina that can result in the passage of gas and/or stool through a tract. […] The most common causes of rectovaginal fistula are: Trauma or tearing of the perineum (the area between the anus and the vulva) during childbirth, Crohns disease or inflammatory bowel disease, Prior pelvic surgery, An infection, Cancer. […] Those who are most at risk of developing rectovaginal fistula are: Women who have given birth, Women who have had radiation treatments or cancer in the pelvic area, Women who have had pelvic surgery, Also at higher risk are women who suffer from Crohn’s or inflammatory bowel disease.

• #20 Rectovaginal Fistula Symptoms Causes & Treatment

  https://www.drneelimamantri.com/blog/rectovaginal-fistula-symptoms-causes-treatment/

  A rectovaginal fistula is an abnormal and uncomfortable condition caused due to an unnatural connection between the rectum and vagina. […] But what exactly causes this abnormal condition in a woman? […] Some of the most common causes of Rectovaginal Fistula include: Trauma or tear of the perineum during childbirth, Inflammatory bowel disease, An infection or an injury/complication during childbirth, Prior pelvic surgery complication, Cancer in the pelvic area and radiation treatment that follows. […] In addition to the above certain cases anus and rectum infections, faecal impaction (stool stuck in the rectum), infected pouches in intestines, and sexual assault can also lead to Rectovaginal Fistula. […] Though Rectovaginal Fistula is caused by a variety of factors mentioned above not everyone develops it. Women with long and difficult labour, injured perineum, infections, cancer in the pelvic area, and pelvic surgery are at more risk of developing Rectovaginal Fistula.

• #21 Vaginal and Recto Vaginal Fistulas | Bladder & Bowel Community

  https://www.bladderandbowel.org/bladder/bladder-conditions-and-symptoms/vaginal-and-recto-vaginal-fistulas/

  A rectovaginal fistula (RVF) is a tract that connects the vagina and the rectum. […] A fistula usually develops after tissue damage or trauma has occurred to the area. They can develop as quickly as several days or occur after several years of damage. A fistula can be caused by surgery trauma, from chronic illnesses such as Crohns Disease or diverticulitis, radiation therapy or damage caused by childbirth such a tear or infection in an episiotomy wound.

• #22 Rectovaginal Fistula | SpringerLink

  https://link.springer.com/10.1007/978-3-031-19598-3_46

  A rectovaginal fistula (RVF) is an abnormal communicating tract between the epithelialized surfaces of the rectum and vagina that is formed as a consequence of injury or inflammation. The etiologies are vast, ranging from obstetric trauma to inflammatory bowel disease; therefore, several modalities exist for both workup and treatment. […] Significant emphasis is placed on the careful and thoughtful extent of multidisciplinary planning to diagnosis and address rectovaginal fistulas and their underlying etiology.

• #23 Long-Term Complications Of Rectovestibular Fistula And Rectovaginal Fistulas

  https://drgursev.com/long-term-complications-of-rectovestibular-fistula-and-rectovaginal-fistulas/

  Rectovaginal and rectovestibular fistulas can be caused due to various reasons and they are only found in female patients. The exact reason behind congenital rectovaginal rectovestibular fistulas is still unknown; however, medical experts suggest that it might be caused by certain prescribed drugs, diet or the environment of the mother. […] Rectovaginal fistula can be caused in adults due to various reasons such as complications during childbirth, inflammatory bowel disease or complications during pelvis surgery. Cancer and its treatment in the vagina, cervix, rectum, uterus, or anus can also cause small holes in the nearby organs, leading to rectovaginal rectovestibular fistula.

• #24 Recto-vaginal fistula – Primary Care Notebook

  https://primarycarenotebook.com/pages/gastroenterology/recto-vaginal-fistula

  Rectovaginal fistula (RVF): RVFs are epithelial-lined tracts between the rectum and vagina – the majority of RVFs are located at or just above the dentate line. […] Causes: most common cause is obstetric injury. Other causes in descending order of frequency include radiation injury, inflammatory bowel disease (IBD, most often Crohn disease), operative trauma, infection, and neoplasm. […] there are many causes of RVFs: perineal lacerations during childbirth, particularly those due to episiotomy, predispose patients to RVFs. […] the development of an RVF may be predisposed by a prolonged labour. Pressure on the rectovaginal septum can produce necrosis and a consequent RVF. […] IBD (Crohn’s and ulcerative colitis) have been associated with developments of RVF. […] radiation therapy used in pelvic malignancy may be complicated by development of a RVF. […] rectal or vaginal operations may cause a RVF. […] pelvic operations can be complicated by the development of a RVF. […] infection may cause a RVF.

• #25 Minimally invasive endoscopic repair of rectovaginal fistula

  https://www.wjgnet.com/1948-9366/full/v14/i9/1049.htm

  The etiology was classified as: related to surgery (n= 51) such as rectal surgery, pelvic surgery and the colorectal anastomosis, with 22 patients undergoing rectal surgery with a history of radiotherapy; and directly caused by radiotherapy (n = 1), inflammatory bowel diseases (n = 5) including Crohn’s disease and ulcerative colitis; congenital (n = 3), obstetric injury (n = 7), trauma (n = 2), with the etiology unclear in two patients. […] Although the techniques for RVF repair have been developing, the etiology, classification, surrounding tissue condition, prior treatment procedures and the surgeons’ preference are always the basis for determining the approach.

• #26 Rectovaginal fistula – St Mark’s The National Bowel Hospital

  https://www.stmarkshospital.nhs.uk/services-a-z/rectovaginal-fistula-delormes-rectal-advancement-flap/

  What causes a rectovaginal fistula? The most common cause is injury to the tissue between the rectum and the vagina during childbirth. This is called an obstetric injury and occurs in a very small proportion of women who undergo a severe tear during vaginal delivery. The next most common cause is an inflammatory bowel disease called Crohns disease. Surgery to the rectum or gynaecological organs, cancer, radiotherapy and some infections can also cause them. […] Treating a rectovaginal fistula can be very difficult. The cause of the fistula, its location and whether or not the anal sphincter is intact may influence the choice of treatment. […] A fistula caused by Crohns disease may be treated with Crohns medications in the first instance to try and encourage it to heal.

• #27 Rectovaginal Fistula: Causes, Symptoms, And Treatment – Surgical Expert in Chandigarh

  https://drrajeevkapoor.com/rectovaginal-fistula-causes-symptoms-and-treatment/

  Rectovaginal Fistula: Causes, Symptoms, And Treatment […] A rectovaginal fistula (RVF) is a distressing medical condition characterized by an abnormal connection between the rectum and the vagina. This connection leads to the passage of stool or gas from the rectum into the vagina, causing significant discomfort, embarrassment, and potential health issues. Lets explore the causes, symptoms, diagnosis, and treatment options for rectovaginal fistulas. […] There are several types of RVFs, including congenital (present from birth) and acquired (developed due to an injury or medical condition). The most common acquired RVFs result from obstetric complications during childbirth, surgical complications, inflammatory bowel diseases like Crohns disease, or radiation therapy for pelvic cancers. […] Understanding the underlying causes of RVFs is essential for proper management. Common causes include: […] Obstetric injuries during childbirth. […] Surgical complications (e.g. after colorectal surgery). […] Inflammatory bowel diseases (e.g. Crohns disease). […] Radiation therapy for pelvic cancers. […] Trauma or injury to the pelvic area. […] The rectovaginal fistula can significantly impact a persons physical and emotional well-being. Early diagnosis and appropriate treatment, which may include surgery, are essential for managing this condition effectively.

Zobacz więcej