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Has anyone had personal experience with rectovaginal fistula repair?
After surgery in August for hemorrhoids and rectal prolapse I was left with fecal incontinence. Soon after going home from the hospital I noticed fecal matter coming also from my vagina. My surgeon said that may have occurred when an attempt was made to remove a fecal impaction that was found during the surgery. He then recommended doing a temporary colostomy. This was intended to allow the rectum and colon to heal for a future repair of the fistula. This was done in September. The morning after the colostomy surgery, my surgeon announced that the 'bridge' ( small plastic piece intended to support the loops of bowel ) was missing. He did not know when or where it had gone. I spent several days in the hospital but eventually went home and had Homecare visits to instruct and help us with the emptying and cleaning of the ostomy appliance. With no support for the bowel loops, my stoma was recessed and has become extremely recessed in the next months. This makes for more difficult care and now the opening that is meant to empty into the pouch, has recessed to the point where it has sunk to to the bottom of the area, barely visible. This may be the reason that i have as much output of stool rectally as into the pouch. After a couple of ER visits, one for ostomy pouch leaking bloody stool, and one for urinary retention, and later, a blood clot, I had lost confidence in my surgeon. My family all was urging me to seek a specialist. I did find a surgeon and now am scheduled for a Rectal Exam under Anesthesia with possible rectal flap procedure or possible SETON placement. He told me that in my situation I have probably less than a 50-50 chance of regaining normal bowel function. He also was less than encouraging about fistula repair outcomes. I am looking at this with more and more trepidation and can't find much online that leads me to believe this will be a positive experience. My primary care physician also made the remark "I hope he told you this is a difficult problem to fix." Do I have a choice? I feel now that everything is broken beyond repair. As of now, I'm spending most of my mornings in the bathroom, first emptying my pouch, sitting on the toilet trying to allow stool to exit my rectum but afraid to strain to help it.....and having the constant feeling of needing to have a bowel movement, As soon as I get cleaned up and stand up from the toilet, I have the urge again to sit back down. My new surgeon suggested tap water enemas for a week to clear out the colon. I did this and the first day I did get results but after that, the water squirted right back out as though it was hitting a wall. Then it seemed as though it might be exiting through the fistula. I stopped the enemas because I was afraid I was going to make the fistula worse. I'm counting the days until my procedure just after the first of the year. I have doubts that I will ever be in a condition which will allow reversal of the colostomy. At this point, I could deal with the ostomy if I did not also have to coax out the stool in my rectum. Has anyone out there had a successful fistula repair?
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Thank you for sharing! I also have a very supportive husband. Helps with the (&*^$&^*) bag and all of my chores in addition to his own, drives me to all my appointments. He's been a Godsend. Hopefully the worst will be over in 3 weeks but I'll still have a long recovery. I'll certainly need that good luck!
Thanks for sharing! Even more hope!
Bless you and I wish you all the best of outcomes! These situations are so devastating and I was very lucky that mine shocked me into a sort of numbness in which I felt apart from myself. With each new blow I still had faith in the medical profession that things would somehow turn out all right. I was also very lucky that my husband was there taking care of me and that (&*^$&^*)_ bag until I decided to take on the responsibility myself. Again, the very best of luck!
I had Diverticulosis for over 15 years and developed a fistula which no doctor wanted to repair When my Diverticulosis no longer could be controlled with antibiotics I had to have a colostomy and it was repaired during the surgery and 18 months later it is fine
I know this is an old thread so you might not see it but on the off chance you will, I wanted you to know I'm grateful you posted. It gives me hope. I have a different kind of fistula, enterocutaneous I think is what it's called. The fistula opened my surgery incision. Losing some blood with it but I also have stage 4 cancer so no surgery while I'm doing chemo. 6 months of chemo later and a good PET scan result and I'm scheduled for surgery in a few weeks. I'm scared to death and excited at the same time. I'm soooo ready to be done with the wound pouches. They're like ostomy pouches but bigger. And since it's not an ostomy with a stoma, the intestine is down in the 5-inch wide hole which is in a crease so there's lots of skin exposed. I cover it with moldable barrier rings and strips but the acids eat away at it. So it should be changed in 2 days to keep the skin from burning too much but I have to try for 3 because I can't afford the pouches and I'm battling the insurance company to cover them. Didn't mean to go into all this. Just wanted to say thank you for sharing!
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2 ReactionsI did have one with diverticulosis and it was repaired when I had my colostomy Prior to that no one would operate just to fix the fistula itself
@blinken Thank you for taking the time to answer! I'm glad you found a doctor who attended you well and are now doing better. I can imagine that doing everything in an organized and disciplined way takes a lot of effort, but it pays off. You're giving me hope.
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2 Reactions@bjbrocks Wishing you the best in your recovery!
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1 ReactionToday is my first day home from surgery. I had a complete hysterectomy with omental flap and sigmoid colon resection. My fistula was between my uterus and colon and caused by diverticulitis.
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2 ReactionsHello, verol65, yes, this is an old post and to pick up sort of where this left off, that surgeon was not able to find the fistula. Also, by my second visit with him, I no longer passed stool vaginally. He wanted to refer me to a facility which would perform some sort of test to see if I would be able to pass stool rectally when and IF the colostomy were reversed and fistula is repaired. He also admitted that he didn't really know what to do with me and would be consulting some experts (I thought that's what HE was). When I asked who that would be, he said "the people who taught me". This left me with an unsettled feeling so I restarted my search and found a well-credentialed colorectal surgeon in Madison, WI. He was located at a Colorectal clinic and did his surgeries at UW Hospital. Students accompanied him into the exam room. His digital exam assured him that I would be able to pass stool myself but he also was unable to detect the fistula. So he also ordered an exam under anesthesia, which did NOT prove a fistula still existed. He ordered barium studies which also did not show an open fistula. He studied the scans and concluded that he would do the reversal of the colostomy and did not believe the fistula was still open. He did also say though that if indeed it had healed, it could reoccur.
My ostomy was reversed and I am passing stool daily, rectally. I am dedicated to eating foods that are high in fiber, try to drink plenty of water, exercise daily and keep a regular schedule. In other words, I have to work at it and so far it has been successful. It can be a chore and I don't often leave the house before 10 a.m. because things can take awhile but every day I thank my lucky stars that I don't have the colostomy or an open fistula! And I was SO fortunate to have found the doctor who was not afraid of my bungled up system. He assured me he had done a lot of reversals and was confident of a good outcome for me. It pays to keep looking to find a doctor who truly excels at what he does!
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