Is dilation safe w vag fistula?

After some intense rectal fistula repair surgeries, I found out I also have a vaginal fistula as well.  The surgeon said it was only pea sized back in April, so no need to repair.  Now, with increased symptoms, Ive convienced him to take a look, scheduled for Dec.  I currently need to have a unrelated procedure that includes opening me up and dialation.  I am very affraid to allow this, bc if the fistula is bad enough to cause recto vag fist. symptoms, that is will open it up or rip me apart!?  Im self pay and state funded, so the NP that needs to dialate me may not be equiped to handle such recourse, yet, if I tell her, she wont touch me, and I need this asap.  Is it safe to be dialated?

[sherrieP]

This is an extremely intricate scenario, I truly feel you need to get feedback from one of the urogyns on the dr side of the forum on this situation. I am not able to transfer the post over so you'll have to copy/paste it to urogynecology on the dr side and I'll send an email to admin to please flag the docs to address it quickly. Hang on a bit longer, I'm hopeful we can get you an answer right away.
Sher

[J. Kyle Mathews, MD, DVM]

Hi,  

Sorry to read of your problem.  As I understand it you currently have a small rectovaginal fistula. I would expect this to be symptomatic if it is a true fistula.  Passing gas through the vagina, possible discharge, etc.  I would agree this needs to be repaired.  Not sure why vaginal dilation would indicated unless you have scar tissue present or if the surgeon is talking about opening the area up for repair.  More information would be helpful.

J. Kyle Mathews, MD