Rectovaginal Fistula Market Size & Share, by Type (High Rectovaginal Fistula, Low Rectovaginal Fistula, Midzone Fistula); End use; Indication; Treatment - Global Supply & Demand Analysis, Growth Forecasts, Statistics Report 2025-2037

Growth Drivers

• Increasing delivery injuries: One of the most frequent causes of recto-vaginal fistulas is injuries sustained during delivery. This includes an episiotomy infection, which is a surgical incision made to expand the perineum during vaginal delivery, or a perineum tear that spreads to the colon. These might happen after a protracted, challenging, or otherwise challenging labor. These fistulas may also involve damage to the anal sphincter, which is a muscle ring at the end of the rectum that helps with holding.
  
  Therefore, the incidence rate of recto-vaginal fistula is expected to rise as a result of an increase in the prevalence of birth injuries. NIH reported that the prevalence of maternal damage with any type of perineal trauma after vaginal delivery ranges from 16.2% to 90.4% globally. Both the incidence of cervical lacerations and the frequency of obstetric anal sphincter injuries are rising rapidly.
• Growing prevalence of radiation-induced RVF: The main cause of rectovaginal fistula formation is thought to be pelvic irradiation. All skin layers, as well as the epidermis, dermis, subcutaneous tissue, and arteries, are affected by late radiation-induced skin damage. Vascular sclerosis causes arteriole constriction or obliteration in small arteries, which in turn causes persistent ischemia and inadequate tissue perfusion. Dense, inelastic fibrotic tissue progressively replaces the irradiated dermis and subcutaneous tissues. The patient may get proctitis, anterior rectal wall ulceration, and fistula after radiation therapy.
  
  Therefore, the growing prevalence of cancerous tumors in regions, such as the uterus, rectum, vagina, anal canal, or cervix, led to the development of recto-vaginal fistula. For instance, according to the World Health Organization, with almost 660,000 new cases in 2022, cervical cancer ranks as the fourth most frequent malignancy in women worldwide. Approximately 94% of the 350,000 cervical cancer-related fatalities that year happened in low- and middle-income nations. Moreover, radiation therapy undertaken to treat cancer in these body parts increases the risk of the development of recto-vaginal fistulas.
• Advancements in treatment methods: One of the most significant developments in surgery over the past few decades has been using minimally invasive methods, which will likely continue to be popular. To prevent tissue incision, sphincter injury, and intraoperative bleeding, endoscopic clipping is a minimally invasive procedure that entails the transrectal implantation of endo-clips for RVF closure. It is appropriate for minor fistulas and even suggested for high-level fistula repair.
  
  Moreover, advances in tissue engineering and regenerative medicine have led to the development of biomaterials and grafts that can be used to repair and reconstruct damaged tissues. Furthermore, newer surgical approaches, such as the Martius flap procedure and the gracilis muscle interposition, have shown promising results in repairing complex fistulas.

Challenges

• Lack of awareness and social stigma: The most prevalent causes of RVF are trauma from sexual abuse or iatrogenic surgical injuries, female genital mutilation, and obstetric difficulties such as protracted labor or perineal tears. Debilitating health symptoms, social isolation, economic disempowerment, psychological trauma, low self-esteem, and a lack of role fulfillment are all experienced by women who have this illness. One of the biggest obstacles to prompt, safe obstetric care and the treatment of follow-up issues like RVF is a lack of easily available, high-quality, and efficient healthcare. Women are also at risk of developing fistulas due to social, cultural, financial, and systemic hurdles, which often cause delays in seeking and obtaining care. Also, there is a lack of awareness of the condition due to its rarity, impeding the growth of the rectovaginal fistula market.
• High costs of the treatment: Treatment for rectovaginal fistula can be expensive, especially for those without insurance or access to reasonably priced health care. Many patients may require multiple surgeries, which can increase the overall cost of the treatment. Also, the cost of pre and post-operative care, including medications and follow-up appointments may hamper the expansion of the rectovaginal fistula market.