Rectovaginal Fistula Due to an Erosive Pessary: A Case Report


  • Waleed Inayat Mohamed University of Health Sciences
  • Dorea Emmanuel Awali Hospital
  • Shahzaib Maqbool Rawalpindi Medical University
  • Ali Asad Royal College of Surgeons in Ireland - Medical University of Bahrain
  • Asad Jawad Doctors’ Hospital
  • Arham Ihtesham Rawalpindi Medical University



Erosive pessaries, Rectovaginal Fistula.


Background: Pelvic organ prolapse (POP) occurs when pelvic organs protrude through the vagina due to displacement from their normal anatomic position, as a result of a weakening of the pelvic muscles. Pessaries have long been used to treat POP, but they may result in rectovaginal fistulas as a rare complication.

The Case: We report a rare case of a rectovaginal fistula following vaginal ring pessary use in an 82-year-old G7P7 woman. She had a past medical history of bipolar disorder, and initially presented for nursing care and psychiatric support. A trained psychologist evaluated her, and found no psychological morbidity. A two-day history of a fall, diffuse abdominal pain, and chronic urinary incontinence were rather identified. Gynecological pelvic examination revealed a rectovaginal fistula and impacted stools in the vagina.

Conclusion: The use of ring pessaries, though a conservative management option for POP, may lead to a rectovaginal fistula, a rare but severe complication.


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2021-12-16 — Updated on 2022-01-06


How to Cite

Mohamed, W. I., Emmanuel, D., Maqbool, S., Asad, A., Jawad, A., & Ihtesham, A. (2022). Rectovaginal Fistula Due to an Erosive Pessary: A Case Report. International Journal of Medical Students, 9(4), 304–306. (Original work published December 16, 2021)