Hello,

There are two types of RVFs - a high one which usually indicates origin from the bowel like Crohns disease or IBD. And low one which indicates that the chances of the RVF originating from the vaginal side is high.

In your case, since the fistula is so small, I suspect that you have a low RVF.

In most cases, the cause of RVF is usually trauma due to childbirth. This is unlikely in your case since you have had the fistula for only about 6months. So, the likelihood of a vaginal infection causing the RVF is high. Vaginal Infection by Lymphogranuloma Venereum (which causes the disease chlamydia) can lead to an RVF. Tubercular infections can also caue RVF. Chlamydia infection is very common in women who use IUCD or tampons.

Since Crohns and IBD has been ruled out by colonoscopy, I believe that you need to be investigated for chlamydia and tuberculosis. If you do have these conditions, you will need medicines to treat them before you can proceed to surgery.

For more, please see:

- http://www.chlamydiae.com/restricted/docs/infections/gentrac_lgv_clinical.asp

- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10449269&dopt=Abstract

I hope this helps.

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