Publication:

Silent suffering: a late presentation of obstetric fistula

Rectovaginal fistulas are uncommon and account for less than 5% of all anorectal fistulas. Obstetric causes include perineal laceration, episiotomy, assisted vaginal delivery, prolonged labour, and trauma to the genital tract. They usually present with fecal incontinence immediately or within 7-10 days. Other causes include inflammatory bowel disease, diverticulitis, gynaecological surgeries, malignancy, and post-irradiation changes.