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Physical exam Your doctor will perform a physical exam to try to locate the rectovaginal fistula and check for a possible tumor mass, infection or abscess. In women, fistulas involving the anal fistula in women and urinary tracts are the most common and happen due to prolonged or obstructed childbirth, injury during pelvic surgery, infection, inflammation, or radiation treatment in the pelvis or genital area. Request an Appointment at Mayo Clinic. Before surgery, your doctor will see whether the tissue is healthy or needs to heal first. A fistula is anal fistula in women abnormal connection via a tunnel-like hole between two organs or vessels.