Successful Treatment of Recto-Vaginal Fistula using the Kshara sutra: A Rare Case Report

Abstract

Rectovaginal fistulas (RVFs) present a persistent clinical challenge, frequently complicated by high rates of recurrence and the significant risk of fecal incontinence following conventional surgical repair. ​These abstract details the successful treatment of a RVF in a 24-year-old female patient using the Kshara Sutra—an ancient herbal medicated seton. ​The procedure involved the application of the Kshara Sutra t following the administration of local Anaesthesia (lidocaine 2%) near the fistula tract. The thread was meticulously replaced weekly in an outpatient setting over a period of four weeks. Crucially, the treatment was completed without any complications, including foul smelling vaginal discharge, recurrent vaginal infection and passage of stool and air through the vagina. Following the intervention, the patient achieved complete fistulous tract healing and has remained fistula-free for the past 6 months. This case demonstrates that the Kshara Sutra offers a safe, effective, and minimally invasive alternative for treating RVF, circumventing the complications typically associated with more aggressive surgical approaches.