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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.
Rectovaginal fistulae are often the result of trauma during childbirth in situations where there is inadequate health care, such as in some poor third world countries. Rates in Eritrea are estimated as high as 350 per 100,000 vaginal births. Women with rectovaginal fistulae are often stigmatized in these countries, and become outcasts.
Rectovaginal fistulae can also be symptoms of various diseases, including infection by Lymphogranuloma venereum, or the unintended result of surgery, such as episiotomy or sexual reassignment surgery.
They may present as a complication of vaginal surgery, including vaginal hysterectomy. They are a recognized presentation of rectal carcinoma or rarely diverticular disease of the bowel or Crohn's disease.
They are seen rarely after radiotherapy treatment for cervical cancer.
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