Single Surgical Procedures in Obstetrics and Gynaecology–34: Fistula Operations-A Colour Atlas of Rectovaginal and Vesicovaginal Fistula
Acquired rectovaginal fistulas in the lower vagina are a result of trauma. Pelvic abscess may rupture either into the rectum or vagina or both, resulting in a high rectovaginal fistula. A complete perineal tear as a result of obstetrical trauma, fall on a sharp object, bull horn injury or rape in the prepubertal females requiring a primary repair followed by an inadequately healed complete perineal tear repair results in the formation of a rectovaginal fistula. Though, not very common, this produces incontinence of flatus and faeces which cause the sufferers to isolate themselves from society. The incidence of pressure necrosis fistulas which are almost invariably the result of "bad midwifery" have reduced with the prevalence of hospital confinements and the thrust on National Health Programmes to promote hospital confinements.
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Narendra Malhotra