Abstract
Colovaginal and/or rectovaginal fistulas cause significant and distressing symptoms, including vaginitis, passage of flatus/feces through the vagina, and painful skin excoriation. These fistulas can be a challenging condition to treat. Although most fistulas can be treated with surgical repair, for those patients who are not operative candidates, limited options remain. As minimally-invasive interventional techniques have evolved, the possibility of fistula occlusion has enriched the therapeutic armamentarium for the treatment of these complex patients. In order to offer optimal treatment options to these patients, it is important to understand the imaging and anatomical features which may appropriately guide the surgeon and/or interventional radiologist during pre-procedural planning.
Highlights
Review of Current Literature on Vaginal FistulasVaginal fistulas account for some of the most distressing symptoms seen by clinicians today
Colovaginal and/or rectovaginal fistulas cause significant and distressing symptoms, including vaginitis, passage of flatus/feces through the vagina, and painful skin excoriation
After radiation treatment of cervical cancer, the incidence of vesicovaginal and rectovaginal fistulas varies from 1% to 8%, respectively [2]
Summary
Vaginal fistulas account for some of the most distressing symptoms seen by clinicians today. The etiology of vaginal fistulas includes obstetrical complications, inflammatory bowel disease, post-surgical causes, pelvic malignancies, trauma, infection, congenital conditions, and radiation effects [2]. After radiation treatment of cervical cancer, the incidence of vesicovaginal and rectovaginal fistulas varies from 1% to 8%, respectively [2] Another common cause of fistulas in the developed. Oral contrast is clearly advantageous in the evaluation of rectovaginal or anovaginal fistulas, in delineating a tract, and in the identification of focal areas of bowel-wall thickening. Once diagnosis has been achieved, the management of patients with vaginal fistulas is as much determined by their etiology as by physical factors, including the size, location, and complexity of the tract. Conservative management has been utilized in some cases, the vast majority of patients are treated surgically, with a new and evolving subset of patients receiving novel treatment with interventional assistance
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