Abstract
Rectovaginal fistula (RVF) is an abnormal connection between the rectum and vagina
that affects women globally. In low- and middle-income countries (LMIC), RVF is most
commonly due to obstetric complications such as prolonged labor or perineal tears,
female genital mutilation and trauma such as sexual violence or iatrogenic surgical
injuries. Women affected by this condition suffer from debilitating physical symptoms,
social isolation, economic disempowerment, psychological trauma, low self-esteem,
and loss of role fulfillment. Lack of accessible, high-quality, and effective healthcare
is a major barrier to timely and safe obstetric care and to care for subsequent complications
such as RVF. Additionally, social, cultural, financial, and systemic barriers put
women at risk of acquiring fistula and contribute to delays in seeking and receiving
care. Literature evaluating RVF repair in those able to access care offers limited
information about management and outcomes. It is difficult to ascertain which surgical
techniques are used. To reduce the burden of this often-preventable disease, appropriate
investment in healthcare infrastructure to strengthen maternal care in LMICs is paramount.
Furthermore, more standardized reporting of severity and treatment approach along
with outcome data are critical to improving the quality of care for patients impacted
by RVF.
Keywords
rectovaginal fistula - maternal care - obstetric complications
