I have had flatulence come out of my vagina for a few years now. I asked my OB/GYN about it and she tried to ignore my question. I kept asking her and she just said that I may have a small hole, but, they didn't do the surgery to correct it there and if it became a nuisance, she could have me referred to another hospital. So, I told her I would just wait. Well, now it's getting worse. It just bubbles out whenever and I have no control over it. Sometimes it smells and sometimes it doesn't. It's extremely embarrassing. Now I was never told this is what it could be, but do these symptoms sound like it's a rectovaginal fistula?
I sometimes have a discharge but not often. I'm told that I am through menopause so could this be due to that? Please advise. I also have irregular bowel movements. It seems I have to go after I eat in the morning and then again after lunch. I really don't eat much in the morning but I usually eat a plate-full of food at lunch. (I'm a teacher so I usually eat the school's lunch.)

Yes, this sounds like a rectovaginal fistula. Whether or not it should be repaired is debatable, particularly since you seem to be dealing with it pretty well. The primary reason to do a repair is when you have a lot of drainage and repeated vaginal or even uterine infections.

However, since you say this is getting worse, then you may want to deal with it. Perhaps just reducing your intestinal gas would be adequate. You may have some bacterial overgrowth and either a short course of Cipro or Flagyl or a low dose long term maintenance may be enough to keep your symptoms at bay. If so, that would be great, because surgical repairs only have a fair success rate.

If your OB/GYN does not want to deal with it, by all means ask for a second opinion with another OB/GYN or a colorectal surgeon. There are several less invasive treatments before opting for extensive repairs.

Jan

Patsy, It does sound like a recto vaginal fistula. I think Jan's advice is the best. you don't want to go for invasive treatments if you don't have to. I never dealt with my OB/GYN for mine, only my colorectal surgeon and now my GI. I looked up your profile and it doesn't say anyting about IBD (Ulcerative Colitis or Chrohns) or Jpouch surgery. Do you have a jpouch? If not, you may not have a colorectal surgeon but I'm sure someone can recommend one on this site based on where you live.

The fistulas are hard to treat but harder if you have no colon and a jpouch. If you don't have a pouch it may be easier to treat so I would definately contact 2nd and 3rd opinions. In the meantime Cipro or Flagyl (or a combo) will help keep infection away. I wish you the best of luck. Let me know if you have anymore questions. thanks. Kim

Thank you Jan and Kim for replying. I feel my case is so insignificant after reading about others. I had never even heard of a jpouch until I starting reading about them at this site. so, obviously, I don't have one.

My family doctor thought I might have IBS. He sent me to have a colonoscopy and an endoscopy. The colonscopy showed that I have diverticula, but not, diverticulitis. So, that was the end of that. He told me not to eat seeds.

I asked my ob/gyn and well, she just wasn't concerned. Do I have to be referred to a colorectal doctor? Also, what is this Cipro or Flagyl you talk about? Do I need a prescription for it? I don't have alot of drainage but I do wear a pad every day because I just never know.

Years ago I had a duodenal ulcer. I learned that it could come from bacteria. I also have diabetes and lately, I haven't been able to keep it under 120. I break out in a sweat throughout the day and at least twice during sleep every night. Could this mean that I have a low-grade temp that may be from internal bacteria? I used to think it was from menopause but I'm supposed to be through that now.

I'm on insulin and I also take medication for an irregular heartbeat. But, something else is going on inside. My sister just had emergency surgery and had 6 inches of her bowel removed. She also had the flatulence through her vagina but she had diarrhea come through too. Not once did she mention to me that she had a rectovaginal fistula. I don't think her doctors said anything about that. In any case, I think I'm headed in the same direction if I don't do some research on it myself.

Patsy, It sounds like you need to see a GI doctor and get some additional tests done especially if you sister is having bowel issues. Most of us here have IBD (which is Ulcerative Colitis and/or Chrohns). I had never heard of these conditions either and had problems a few years ago and was diagnosed. Because you still have a regular anatomy (no jpouch surgery) fixing a fistula might be easier. It tends to be tougher on those like us who have the jpouch. I am sure someone will come by who is better versed in the medical terminology but I wonder what is causing your fistula? I think a GI doctor or a Colo rectal surgeon would be helpful in giving you more options. I wish you the best of luck and wish I was more helpful. Let me know if I can do anything else.

After having my daughter I had two direct communications between the rectum and the vagina. Since I don't have a colon I would have gas and poop come out the front end. My OB/GYN ignored me too especially since he knew the whole thing was his fault. I eventually sued him and won. The last time he dismissed my compaints I headed to a surgeon in Louisville who trained with Dr. Fazio. She said that not only did I have those communications, I also had a raging infection that could have ended up killing me because of the ob's ignorance. I ended up having a total reconstruction. I really had no other choice. I did end up losing sensation in places but it resolved the problem pronto. The key is finding a good surgeon. Hang in there!