Transanal Repair for Rectovaginal Fistula

Overview

A rectovaginal fistula is an abnormal connection between the rectum and the vagina, causing fecal matter or gas to pass through the vagina. This condition can significantly impact a woman’s quality of life, leading to discomfort, infections, and emotional distress. One of the effective surgical treatments for this condition is transanal repair. In this blog, we will explore what a rectovaginal fistula is, the causes and symptoms, the transanal repair procedure, and what to expect during recovery.

What is a Rectovaginal Fistula?

A rectovaginal fistula is a passage that allows the contents of the bowel to leak into the vagina, leading to symptoms such as:

• Fecal Incontinence: Involuntary leakage of stool through the vagina.
• Passing Gas Through the Vagina: Air passes through the vagina, causing embarrassment and discomfort.
• Recurrent Infections: Frequent vaginal and urinary tract infections.
• Vaginal Discharge: Persistent and foul-smelling discharge.

Causes of Rectovaginal Fistula

Rectovaginal fistulas can result from various causes, including:

• Childbirth Trauma: Prolonged labor, the use of forceps, or episiotomy during childbirth can cause tears that may lead to fistula formation.
• Surgical Complications: Previous surgeries involving the rectum, vagina, or perineum can sometimes result in fistulas.
• Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease or ulcerative colitis can cause chronic inflammation and lead to fistula formation.
• Radiation Therapy: Treatment for pelvic cancers can damage tissues and lead to fistulas.
• Infections: Severe infections in the pelvic area can result in the formation of fistulas.

What is Transanal Repair?

Transanal repair is a surgical technique used to close the rectovaginal fistula through the anus. This minimally invasive approach provides direct access to the fistula, allowing the surgeon to repair the abnormal connection without making external incisions. This procedure is often chosen because it reduces the risk of complications and promotes quicker recovery compared to traditional open surgeries.

The Transanal Repair Procedure

1. Preparation:
   • Before the procedure, a thorough medical evaluation is conducted, including imaging studies such as MRI or CT scans to determine the exact location and size of the fistula.
   • Patients may need to follow a special diet and use bowel preparation techniques to cleanse the bowel before surgery.
2. Anesthesia:
   • The procedure is typically performed under general anesthesia, ensuring the patient is unconscious and pain-free during the surgery.
3. Surgical Procedure:
   • The patient is positioned to provide the surgeon with clear access to the anal canal and rectum.
   • A retractor is used to keep the anal canal open, and the fistula is carefully identified.
   • The surgeon removes any scar tissue and infected material surrounding the fistula.
   • The rectal and vaginal openings of the fistula are then closed with sutures. Sometimes, a piece of healthy tissue (a flap) may be used to reinforce the repair and promote healing.
   • The area is thoroughly cleaned, and the retractor is removed.
4. Post-Procedure:
   • After the surgery, the patient is monitored in the recovery room for a few hours.
   • Most patients can go home the same day or the following day, depending on their condition and the extent of the surgery.

Recovery and Aftercare

Recovery from transanal repair involves several important steps:

1. Activity Restrictions:
   • Patients are generally advised to avoid strenuous activities, heavy lifting, and sexual intercourse for several weeks to allow the surgical site to heal properly.
2. Dietary Guidelines:
   • A high-fiber diet and adequate fluid intake are recommended to prevent constipation and reduce strain during bowel movements. Stool softeners or laxatives may be prescribed to ease bowel movements.
3. Pain Management:
   • Mild pain and discomfort are common after the surgery. Over-the-counter pain relievers or prescribed medications can help manage these symptoms.
4. Hygiene and Care:
   • Maintaining good hygiene in the anal and vaginal areas is crucial to prevent infections. Patients should follow their healthcare provider’s instructions for cleaning the surgical site.
5. Follow-Up Appointments:
   • Regular follow-up appointments are necessary to monitor the healing process and ensure that the fistula has been successfully repaired. Any signs of complications, such as fever, severe pain, or unusual discharge, should be reported to the healthcare provider immediately.

Benefits of Transanal Repair

Transanal repair offers several key benefits:

• Minimally Invasive: The procedure avoids external incisions, reducing the risk of complications and promoting quicker recovery.
• Effective Symptom Relief: Repairing the fistula can alleviate symptoms such as fecal incontinence and recurrent infections, significantly improving the patient’s quality of life.
• Reduced Hospital Stay: Most patients can return home within a day or two after the procedure.

Risks and Complications

While transanal repair is generally safe, it does carry some risks, including:

• Infection
• Recurrence of the fistula
• Bleeding
• Pain or discomfort during bowel movements

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, and doctor, for transanal repair for rectovaginal fistula at the lowest costs. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!