Brief Answer: Doing contrast study is the confirmatory way Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day In my opinion annual rectal wash out is not sufficient to remove the retained secretion. I usually advise my patients alternate day washout at home. ( Every Surgeon has their own protocol after all). Vaginal discharge could be because of many causes apart from thrush. Ad treatment for thrush has not helped , some alternate diagnosis has to be sought for diagnosis. As you are suspecting vaginorectal fistula, which could be possible even though unlikely presenting after so many years. Following are the ways to prove or disprove the diagnosis 1. Look for discharge from anus or rectal stump stoma: If the discharge is same as that of vaginal discharge then the possibility of rectovaginal fistula becomes more likely 2. Rectal washout: If you have been taught rectal wash out at home then doing this at home and the irrigation fluid coming out through the vagina confirm the diagnosis. 3. Confirmation of diagnosis: Doing a XXXXXXX study by using radioopaque contrast material for doing rectal washout and taking X ray is the way for ruling out the possibility of fistula. It's unlikely to be fistula, even if it turns out to be fistula it will cause no much problem till your next visit to your colorectal Surgeon. Do get back to me if you need any further assistance, will be glad to assist you. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Surgeon

---