Rectovaginal Fistula (RVF) Repair is a procedure that involves the surgical repair of an abnormal tract between the large intestine, rectum, and vagina, in women. A Rectovaginal Fistula Repair procedure involves the vagina, rectum, surrounding tissue and blood vessels, and nerves within the perineum.
How a rectovaginal fistula repair surgical procedure is performed?
What are the reasons behind rectovaginal fistula repair surgical procedure?
The Rectovaginal Fistula Repair procedure is performed in women for the following reasons:
- The Rectovaginal Fistula Repair procedure may be performed under general, regional, or local anaesthesia.
- For rectovaginal fistula that is situated lower (nearer to the anus or vagina), the tract may be repaired by approaching it either via the anus and rectum (lowermost portion of the large intestine, in transanal approach) or the vagina (transvaginal approach)
- The fistula tract is identified and repaired by raising flaps of the wall tissue, curetting (removing tissue) the wall of the tract, and suturing the flaps in place
- Rectovaginal fistulas that are situated higher up are repaired in a similar manner after approaching the fistula, by making an incision on the skin of the abdomen and dissecting through the layers
The Rectovaginal Fistula Repair procedure may be performed by an Obstetrician-gynaecologist
or a General surgeon
. The procedure may take an hour or so to perform, depending on the surgical approach.
Preparations needed before a rectovaginal fistula repair surgical procedure
Diagnostic lab tests needed before a rectovaginal fistula repair surgical procedure
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are currently being taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time before the procedure is performed
- Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
- Inform the physician if you are allergic to any local anaesthetics, lidocaine, etc.
- Avoid application of any cosmetics, deodorant, or topical medicines on the area prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range if not, their diabetologist may have to control blood sugar by recommending insulin or a combination of oral medicines
Before a Rectovaginal Fistula Repair, the patient has to undergo certain tests such as:
Risks and complications during rectovaginal fistula repair surgical procedure
The possible risks or complications that may arise during the Rectovaginal Fistula Repair surgery are:
Risks and complications after rectovaginal fistula repair surgical procedure
- Excessive bleeding
- Infection of the surgical wound
- Anaesthetic complications
The possible risks and complications that may arise after a Rectovaginal Fistula Repair procedure are:
Post-operative care needed after a rectovaginal fistula repair surgical procedure
- Excessive bleeding
- Infection in the surgical wound
- Incomplete healing of the fistula
At home, the following post-operative care is recommended after a Rectovaginal Fistula Repair procedure:
- Slowly resume daily activities as early as possible, which aids in faster recovery
- Avoid all activities that are physically strenuous for about 6 weeks, or follow the physician’s advice
- Resume showering and keep the wound clean and dry. Avoid taking baths until the surgical wound is completely healed. Gently wash the surgical wound with mild unscented soap
- Complete the course of prescribed medication as advised by your physician
- Avoid constipation and stress during urination and bowel movements. Take stool softeners to prevent constipation (under advice of the physician)
- Take antibiotic medication to help combat or prevent infection, per your physician’s advice
- Resume driving 3 weeks after being discharged from the healthcare facility (as advised by your physician)
- Individuals are advised to wait until the gastrointestinal tract begins properly functioning after surgery, before progressing on to a well-balanced diet. Also increase your fluid and fibre intake to prevent constipation and stress during bowel movements and urination