Neglected pessary causing a rectovaginal fistula: a case report.

Abstract

For patients with a rectovaginal fistula resulting from an impacted vaginal pessary, a 2-stage procedure is required. The first stage, done under anesthesia, includes removal of the pessary and an examination to assess the size and location of the fistula. The second stage is operative management of the rectovaginal fistula, preceded by adequate bowel preparation. The clinician must stress proper pessary maintenance in order to avoid the serious consequences of a neglected pessary.