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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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I had not read the whole thread as I thought. I now understand you did not get the flap. Sorry.
How were your fistulas resolved, @bjbrocks ?
I have a rare rectovaginal fistula due to radiotherapy so the tissue is burned and therefore a flap, even if possible, is not considered a viable solution in the long term because of the high risk of developing a new fistula.
Hi, @blinken! I've just read this thread. This was already three years ago. Did you get the flap? How did that work out for you?
Hello,
My info was for a friend but that doesn't matter. I'm not sure about the name of her surgery but I do know but her bowel movements were going though her vagina. She had many infections that had to be removed and the surgery was quite extensive. I can't imagine how terrible it must have been for your daughter and it should never have happened if the surgery were done expertly which I hope it was. She must have been devastated and I truly don't know how she continued but they gave her no choice. My friend's doctor mentioned a colostomy bag for a while if things didn't work the way they were supposed to. We put all our trust in our doctors, especially surgeons. She is still worrying about it and she is going to see a gastroenterologist in a couple of weeks. My great nephew is transitioning to female but I don't know if he will get surgery or not and I would never ask because it's such a personal matter. How is your daughter doing now? I do feel deeply sorry for her. Is she seeing a therapist which I think would be a good idea because her depression and hopelessness are so intense. I know she doesn't know me but give her my best and I pray that she gets the help that she needs. All my best, Nancy : )
Re this comment I think I put it in the wrong place. Not sure what to do at this point, sorry for the error.
Hello,
My info was for a friend but that doesn't matter. I'm not sure about the name of her surgery but I do know but her bowel movements were going though her vagina. She had many infections that had to be removed and the surgery was quite extensive. I can't imagine how terrible it must have been for your daughter and it should never have happened if the surgery were done expertly which I hope it was. She must have been devastated and I truly don't know how she continued but they gave her no choice. My friend's doctor mentioned a colostomy bag for a while if things didn't work the way they were supposed to. We put all our trust in our doctors, especially surgeons. She is still worrying about it and she is going to see a gastroenterologist in a couple of weeks. My great nephew is transitioning to female but I don't know if he will get surgery or not and I would never ask because it's such a personal matter. How is your daughter doing now? I do feel deeply sorry for her. Is she seeing a therapist which I think would be a good idea because her depression and hopelessness are so intense. I know she doesn't know me but give her my best and I pray that she gets the help that she needs. All my best, Nancy : )
t
I hope you had a positive outcome with the new surgeon. I am so sorry for what you went through! My daughter was only 20 when she went to have sex reassignment surgery, m to f, the doctor gave her a huge fistula, told her she had to have a colostomy which she did for 13 months. Meanwhile, she had eight surgeries to try to close a fistula and still keep some vaginal retention. After the 8th surgery we gave up as a surgeries were extremely painful, decided to get rid of colostomy and just stitch the vagina shut. At least she now has normal bowel function but unfortunately because of the failed surgery to create a vagina she feels very depressed and hopeless. These surgeons should be more careful, one wonders how many lives they have ruined because of their carelessness!
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1 ReactionHi Colleen,
Thank you for moving my info, I appreciate that and thank you for your reply. I will speak with Alma today. : )
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2 Reactions@nscappa, I moved your posts asking questions on behalf of your friend's complications after fistula surgery to this existing discussion so you can connect with other members who have had the same surgery. See:
- Has anyone had personal experience with rectovaginal fistula repair?
https://connect.mayoclinic.org/discussion/has-anyone-had-personal-experience-with-recto-vaginal-fistula-repair/
Like you, I hope the gastroenterologist will have some answers for her. You might encourage her to keep a journal over the next 2 weeks of the symptoms she experiences and her bowel movements, like how often, consistency, etc.
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1 ReactionThank you Ginger. The only issue with being on a cancellation list is that Alma's insurance wants a two notice for doctors' appointments. If the cancellation gave her those two days it would work. She does ask to be put on cancellation lists but it gets tricky re her ride. Thanks again! : )
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1 Reaction@nscappa Suggest to her she call her gastro's office, and ask to be placed on a cancellation list, that may get her in earlier than 2 weeks! Perhaps if she will let them know her issues, they will find space for her?
Ginger