Your first appointment may be with your family doctor, primary care provider or gynecologist. After your initial evaluation, you may be referred to a surgeon who specializes in procedures involving the female reproductive system (gynecologic surgeon) or one who specializes in treating conditions of the colon and rectum (colorectal surgeon) to discuss treatment options.
What you can do
To prepare for your appointment:
- Ask about any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance to prepare for diagnostic tests.
- Make a list of symptoms you're experiencing. Include any that may seem unrelated to a rectovaginal fistula.
- Make a list of your key medical information. Include any other conditions you're treating, all past surgeries, and the names of any medications, vitamins, herbal remedies or supplements you're taking.
- Consider questions to ask your doctor. Make a list, take it with you to your appointment, and make notes as your doctor answers your questions.
For a rectovaginal fistula, some basic questions to ask your doctor include:
- What's causing these symptoms?
- Are there other possible causes for my symptoms?
- What kinds of tests do I need? Do these tests require any special preparation?
- Is this condition temporary or long lasting?
- What treatments are available, and which do you recommend?
- Are there any alternatives to your recommended treatment?
- Will I need surgery?
- Do you have any brochures or other printed material that I can take with me? What websites do you recommend?
Don't hesitate to ask questions during your appointment anytime you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
Oct. 17, 2015
- When did your symptoms begin?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Are you able to have regular bowel movements?
- Do you experience uncontrolled loss of stool, also called fecal incontinence?
- Do you have difficulty with constipation that causes you to strain a lot during bowel movements?
- Have you given birth vaginally? Were there any complications?
- Have you ever had pelvic surgery?
- Have you ever been treated for a gynecologic cancer?
- Have you had pelvic radiation therapy?
- Do you have any other medical conditions, such as Crohn's disease?
- deBeche-Adams TH, et al. Rectovaginal fistulas. Clinics in Colon and Rectal Surgery. 2010;23:99.
- Champagne BJ, et al. Rectovaginal fistula. The Surgical Clinics of North America. 2010;90:69.
- Tintinalli JE, et al. Anorectal disorders. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com. Accessed Aug. 21, 2015.
- Browning A, et al. Characteristics, management, and outcomes of repair of rectovaginal fistula among 1100 consecutive cases of genital tract fistula in Ethiopia. International Journal of Gynecology & Obstetrics. Accessed Aug. 23, 2015.
- Schwartz DA, et al. The role of imaging tests in the evaluation of anal abscesses and fistulas. http://www.uptodate.com/home. Accessed Aug. 21, 2015.
- Fecal incontinence. National Digestive Diseases Information Clearinghouse. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/fecal-incontinence/Pages/facts.aspx. Accessed Aug. 21, 2015.
- Toglia MR. Rectovaginal and anovaginal fistulas. http://www.uptodate.com/home. Accessed Aug. 21, 2015.
- de la Poza G, et al. Genital fistulas in female Crohn's disease patients: Clinical characteristics and response to therapy. Journal of Crohn's and Colitis. 2012;6:276.
- Hoffman BL, et al. Surgeries for female pelvic reconstruction. In: Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com. Accessed Aug. 23, 2015.
- Brunicardi FC, et al., eds. Colon, rectum, and anus. In: Schwartz's Principles of Surgery. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://accessmedicine.com. Accessed Aug. 23, 2015.
- Bowel retraining. MedlinePlus. https://www.nlm.nih.gov/medlineplus/ency/article/003971.htm. Accessed Aug. 26, 2015.
- A question for women's health: Chemicals in feminine hygiene products and personal lubricants. Environmental Health Perspectives. 2014;122:A70.
- Rohren, CH (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 11, 2015.