Rectovaginal fistula

From Jan. 1973 to Dec. 1988, 48 patients with rectovaginal fistula were managed at National Taiwan University Hospital. Etiologies of rectovaginal fistula included: 22 cases (45.8%) were caused by congenital anomaly; 15 cases (31.2%) by pelvic malignamcy; 10 cases (20.8%) by birth injury, operative injury and traffic accident; 1 case (2.0%) by inflammatory bowel disease. Forty out of these 48 patients received definite treatment and were followed up for at least 1 year. Among these 48 patients, operative mortality was 4.8% (2 cases). The operative results were excellent, and most of fistulas were easy to be repaired locally. 87.5% cure rate was obtained in traumatic cases and 90% in congenital cases. On the contrary, the cure rate was low (30%) in malignant cases in spite of aggressive treatment with temporary colostomy and local repair. Our data suggests that the surgical management and outcome of rectovaginal fistula were influenced by the underlying causes.