Abstract Background The literature surrounding rectovaginal fistula (RVF) consists mainly of case series, rendering the true incidence of RVF across aetiologies opaque. This study aims to determine the true incidence of RVF within various aetiological groups across the population of RVF patients in England, using Hospital Episodes Statistics (HES). This is an observational study which aims to present a comprehensive overview of the population of woman affected with RVF in England across different aetiological groups. Methods We utilised the administrative HES database which includes all patient records from admissions across English NHS hospitals. Descriptive data included characteristics such as age, ethnicity, social deprivation and co-morbidities across aetiological subgroups. We analysed all RVF cases extracted from HES from 2003- 2020 from various aetiologies. Results RVF patient episodes between 1 April 2003 and March 2020 were identified and data extracted. Eight subgroups were identified: obstetric injury, Crohn’s disease, radiotherapy, cancer, iatrogenic injury, sepsis, gender affirmation and miscellaneous. Obstetric injury and Crohn’s disease were the commonest aetiologies. The incidence of RVF in common groups such as obstetric injury is 0.02% (1,233 of 4,929,277), median age 35, and in Crohn’s disease 1.4% (2,044 of 149,120), median age 43. A total of 59 out of 2,044 with an RVF had a proctectomy. A total of 8,314 deliveries via Caesarean section amongst the 149,120 cohort of patients with Crohn’s disease were identified (5.6%). Conclusion This study provides a detailed description outlining all the important aetiological groups of patients affected with this devastating condition, with epidemiological data derived from a nationwide cohort over 17 years. The aetiological detail, incidences and demographic details are drawn from a very large, consecutive cohort, and provide a rich source of epidemiological data in this rare disease. Conflict of interest: Sackitey, Charlene: No conflict of interest Bottle, Alex: No conflict of interest Deputy, Mohammed: No conflict of interest Balinskaite, Violeta: No conflict of interest Hart, Ailsa: No conflict of interest Vaizey, Carolynne: No conflict of interest Aylin, Paul: No conflict of interest Tozer, Philip: No conflict of interest
Sackitey et al. (Thu,) studied this question.