Recto-vaginal Fistula Treatment Market: Introduction

According to the report, the global recto-vaginal fistula treatment market was valued at US$ 550.8 Mn in 2020 and is projected to expand at a CAGR of 5.7% from 2021 to 2031. Recto-vaginal fistula can be described as abnormal epithelial line connected between the rectum and vagina. Fistulas can be the outcome of acquired etiologies or congenital malformations. Recto-vaginal fistulas can also be caused due to childbirth. Obstetric injury with a fourth or a third degree perineal tear or prolonged labor with necrosis of the part or episiotomy could result in recto-vaginal fistula. Infection, breakdown of the repair, or improper repair can lead to development of fistula. Infections caused within the recto-vaginal septum can lead to the condition. Bartholin gland infections and crypto-glandular ano-rectal abscess drains cause low recto-vaginal fistula.

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Hysterectomy is performed due to infection caused as a result of fistula. Lymph granuloma venereum and tuberculosis can result in recto-vaginal fistula. Primary classification of the condition is carried out with the help of etiology, size, and location. It categorizes the criteria for recto-vaginal fistulas as complex or simple. Classification of fistula is performed to plan proper treatment and appropriate therapy. Fistulas greater than 2.5 cm in diameter are termed as large and those less than 2.5 cm are considered small.

Rise in Global Burden of Crohn’s Disease

Crohn's disease can be defined as an inflammatory bowel disease, wherein there is an inflammation of the digestive tract lining. A large number of women suffering from Crohn’s disease never develop recto-vaginal fistula. However, suffering from Crohn’s disease increases the risk of this condition. Hence, prevalence of recto-vaginal fistula is projected to rise during the forecast period owing to increase in incidence of Crohn’s disease. The number of people with IBD in Canada stood at around 270,000 (0.7%) as of 2018. This number breaks down as 135,000 individuals living with Crohn's disease and 120,000 with ulcerative colitis.

In 2017, around 6.8 million (95% UI 6.4-7.3) cases of IBD were recorded globally. The age-standardized prevalence rate increased from 79.5 (75.9-83.5) per 100,000 population in 1990 to 84.3 (79.2-89.9) per 100,000 population in 2017. The number of new cases reported is expected to rise in developing countries compared to developed countries owing to westernized dietary patterns, increase in use of antibiotics, rise in exposure to pollution, and improvement in hygiene.

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The highest increase in incidence of these conditions is reported in countries such as Finland, Denmark, and Sweden, with the highest incidence of CD at 9.2, 8.6, and 8.3 per 105 cases, respectively. Moreover, Sweden (213 per 105 cases) and Denmark (151 per 105 cases) rank first and second in the prevalence of CD in Northern Europe and even in whole Europe, respectively.

High Rectovaginal Fistula Segment to Lead Global Market

In terms of type, the global recto-vaginal fistula treatment market has been classified into high recto-vaginal fistula, low recto-vaginal fistula, and midzone fistula. The high recto-vaginal fistula segment is projected to account for major share of the market by 2031. High RVFs are located between the middle third of the rectum and the posterior vaginal fornix. These require a transabdominal surgical repair approach.

The high recto-vaginal fistula segment is expected to register market attractiveness index of 2.6 during the forecast period, as these fistulas often involve the posterior vaginal fornix. Typical causes are radiation, ulcerative colitis, diverticulitis, and cancer.

Hospitals Segment to Lead Global Recto-vaginal Fistula Treatment Market

Based on end-user, the global recto-vaginal fistula treatment market has been divided into hospitals, ambulatory surgical center, and others. The hospitals segment is projected to account for significant share of the market by 2031. The hospitals segment is expected to register higher market attractiveness index by 2031 owing to high reliance on surgical interventions for treating recto-vaginal fistula. Introduction of advanced surgical techniques with minimal hospital stay and minimal invasion is increasing the number of surgeries being performed at ambulatory surgical centers. Moreover, hospitals are the sole providers of recto-vaginal fistula surgical treatment in emerging and underdeveloped markets.

Surgery Segment to Dominate Global Recto-vaginal Fistula Treatment Market

In terms of treatment, the global recto-vaginal fistula treatment market has been bifurcated into medication and surgery. The surgery segment is projected to account for major share of the market by 2031. The surgery segment is expected to register higher market attractiveness index during the forecast period, as most of the anal fistula cases need surgical intervention for cure. Surge in incidence of comorbidities such as Crohn’s disease, cancerous & other lethal infections, and changing dietary habits is likely to increase the number of rectal-vaginal fistula cases. Moreover, rise in adoption among surgeons and patients is projected to propel the segment.

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Delivery-related Injuries to be Key Indicator

Based on indication, the global recto-vaginal fistula treatment market has been categorized into Crohn's disease, delivery-related injuries, cancerous tumor treatment, and others. The delivery-related injuries segment is anticipated to account for significant share of the market by 2031. Delivery-related injuries are the most common cause of rectovaginal fistulas. This includes tears in the perineum that extend to the bowel or an infection of an episiotomy, a surgical incision to enlarge the perineum during vaginal delivery. These could happen following a long, difficult, or obstructed labor. These types of fistulas can also involve injury to the anal sphincter, the rings of muscle at the end of the rectum that help an individual to hold stool.

North America to Lead Global Recto-vaginal Fistula Treatment Market

In terms of region, the global recto-vaginal fistula treatment market has been segmented into North America, Europe, Latin America, Asia Pacific, and Middle East & Africa. North America is projected to be a highly lucrative market during the forecast period, with attractiveness index of 1.9. The region accounted for major share of the global market in 2020. North America’s large market share is attributed to early adoption of new technologies and high health care expenditure by the public and private sectors in the U.S.

According to the Centers for Disease Control and Prevention, in 2015, around 1.3% of adults in the U.S. were diagnosed with inflammatory bowel disease such as Crohn’s disease and ulcerative colitis. High prevalence of such co-morbidities is likely to augment the market in the region.

Competition Landscape

The global recto-vaginal fistula treatment market is fragmented due to the presence of a large number of leading players. Key players operating in the global market include Pfizer, Inc., GlaxoSmithKline plc, Sanofi S.A., Takeda Pharmaceutical Company Limited, Johnson & Johnson Services, Inc., W. L. Gore & Associates, Inc., Mount Sinai Hospital, Tubingen University Hospital, St. Mark's Hospital, and Apollo Hospitals Enterprise Ltd. These players hold major market share in their respective regions. Growth strategies adopted by leading players are likely to drive the global recto-vaginal fistula market.

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