Rectovaginal fistula

1. Recto-vaginal fistula
• It is a congenital problem causing
direct communication between
rectum and vagina in female calves.
• Urofecal mixing occurs and vulva (if
it be normal) serves as a common
orifice for both digestive and
urogenital tracts.
• This deformity is accompanied by
atresia ani and blind rectal pouch
ends just anterior to the anus

2. • Partial or complete
fusion of vulvular lips
causes pooling of
excretions leading to
the development of
abnormal bulging in
this area and spoils
the normal contour
of the area.

3. Treatment
If vulva fused
• Prepare surgical site
• Infiltration of lignocaine HCl with adrenaline (Jasocaine A 5 ml).
• After development of anesthesia, a 3 inch long incision will be made
at the site of vulvular fusion.
• The fused vulvular lips will be separated by blunt dissection (which
will be yielding the discharge of fecal material containing urine).
• There will be found a direct communication between rectum and
vagina in the form of a long slit locating anteriorly at median plane.

4. For surgical correction of atresia ani,
• 1 inch wide circular skin incision will be made and subcutaneous
tissue will be removed from the approximated site of anus.
• Careful blunt dissection in a forward direction will be made to identify
the blind rectal loop.
• the rectal pouch will be grasp with a pair of tissue forceps and incise
for complete evacuation of rectal passage. The rectal mucosa will be
sutured by using black braided silk # 1 with the skin using simple
interrupted suture pattern covering the whole circumference.
• the communicating fistula between rectum and vagina will be closed
with Chromic Catgut # 1 by using simple interrupted suture pattern.

5. Post operative care
• Injection streptopen 0.5 gm i/m for a period of five days.
• Injection Melvet (0.5 mg/kg) SC/IV/IM as a single dose
• Apply Neomycin Ointment in the newly constructed anus
• Remove silk sutures were removed on 10th to14th post-operative
day.