Rectovaginal Fistula in Crohn's Disease: When and How to Operate?

Clin Colon Rectal Surg. 2022 Jan 17;35(1):10-20. doi: 10.1055/s-0041-1740029. eCollection 2022 Jan.


Rectovaginal fistula (RVF) occurring during the course of Crohn's disease (CD) constitutes a therapeutic challenge and is characterized by a high rate of recurrence. To optimize the outcome of CD-related RVF repair, the best conditions for correct healing should be obtained. Remission of CD should be achieved with no active proctitis, the perianal CD activity should be minimized, and local septic complications should be controlled. The objective of surgical repair is to close the fistula tract with minimal recurrence and functional disturbance. Several therapeutic strategies exist and the approach should be tailored to the anatomy of the RVF and the quality of the local supporting tissues. Herein, we review the medical and surgical management of CD-related RVF.

Keywords: IBD; complication; emerging therapies; fistula; fistulizing; flap; inflammatory bowel disease; mesh; prosthesis; reconstruction; rectal; rectum; vagina.

Publication types

  • Review

Grants and funding

Funding None.