Finding feces in the vagina implicate an abnormal connection from the large intestines, the rectum, and the vagina. This condition is called rectovaginal fistula. Read below to learn more about causes and treatment options for stool coming out of the vagina.
Genital issues are never a comfortable topic of conversation, and stool in the vagina is an extremely uncomfortable symptom that you may feel too embarrassed to discuss with your healthcare provider.
However, it is important to know that stool in the vagina is never normal, and following-up with your healthcare provider is an important first step in finding a solution to this disconcerting and distressing symptom.
Common characteristics of stool in the vagina
The common characteristics of stool in the vagina are related to the presence of the stool in the vaginal canal. Pus passing out of the vagina may represent the presence of an infection.
Foul-smelling odor that does not resolve (even with proper hygiene)
Gas or pus passing out of the vagina
Fecal incontinence: This is an uncontrolled loss of stool.
Common accompanying symptoms
Stool in the vaginal canal is often not the only symptom. Common accompanying symptoms of this problem include:
Dyspareunia: This is pain during sexual intercourse.
Dysuria: This is pain during urination.
Recurrent vaginal or urinary tract infections
Make an appointment with your healthcare provider promptly if you notice any of the symptoms above. This condition can cause both physical discomfort and emotional distress and requires follow-up with a medical professional.
Stool in the vagina causes
The underlying cause for stool in the vagina is an abnormal connection between the rectum (lower part of the large intestine) and the vagina. This abnormal connection is called a rectovaginal fistula. See an image of a rectovaginal fistula here.
The specific causes of rectovaginal fistula and why it forms can be separated into congenital causes (at birth) and acquired causes that are due to a secondary process occurring later in life.
Acquired causes of stool in the vagina may include the following.
: Traumatic injuries that occur during childbirth can result in rectovaginal fistulas. During childbirth, the perineum can tear, resulting in an opening between the vagina and rectum/anus. Using this image here, you can imagine how this could occur if the perineal body/perineal membrane was torn. If this tear does not heal properly a rectovaginal fistula can form. Furthermore, deliveries that last for a long time can cause too much pressure on the perineum and result in a condition known as pressure necrosis of the rectovaginal septum.
Systemic disease: Systemic diseases that cause generalized inflammation in the body, especially the gastrointestinal tract, can put individuals at increased risk of developing rectovaginal fistulas.
Iatrogenic: Iatrogenic refers to medically-related causes of a condition. In the case of rectovaginal fistula, surgery to the components of the pelvis (vagina, perineum, rectum or anus) or lower pelvic region in general can lead to the development of the condition. For example, during labor sometimes an episiotomy (a surgical incision to enlarge the perineum during vaginal delivery) is performed. The episiotomy may become infected or not heal properly leading to a rectovaginal fistula. Moreover, treatment for cancers in the pelvic region that involve radiation can put patients at risk for development of fistulas as well.
Congenital causes of rectovaginal fistula that are present at birth are rare and much less common than the acquired etiologies discussed above. This condition is known as a rectovaginal or rectovestibular fistula. The cause of this congenital condition is not completely known, but environmental factors such as drug use during pregnancy may play a role.