Repair of simple rectovaginal fistulas - Influence of previous repairs

Ann C. Lowry, Alan G. Thorson, David A. Rothenberger, Stanley M. Goldberg

Research output: Contribution to journalArticlepeer-review

125 Scopus citations

Abstract

The results of 81 endorectal flap advancements for simple rectovaginal fistulas are reported. Simple fistulas are defined as <2.5 cm in diameter, low or mid vaginal septum in location, and infectious or traumatic in origin. Essentially, the technique is advancement of a flap of mucosa, submucosa, and circular muscle over midline approximation of internal sphincter muscle. The mean patient age was 34 years old (range, 18 to 76 years). The causes were obstetrical injury (74 percent), perineal infection (10 percent), operative trauma (7 percent), and unknown (8 percent). Overall, the repair was successful in 83 percent of patients. Success correlated with the number of previous repairs, i.e., none: 88 percent success; one: 85 percent success; two: 55 percent success. There were 25 concomitant overlapping sphincteroplasty procedures. Only minor complications ensued, with no mortality. This repair is recommended for patients with no or one previous repair because of its lack of mortality, minimal morbidity, ease of concomitant sphincteroplasty, and avoidance of a colostomy. For patients with two or more earlier repairs, a muscle interposition should be considered.

Original languageEnglish (US)
Pages (from-to)676-678
Number of pages3
JournalDiseases of the Colon & Rectum
Volume31
Issue number9
DOIs
StatePublished - Sep 1 1988

Keywords

  • Endorectal flap repair
  • Fistulas
  • Rectum
  • Vagina
  • fistula
  • rectovaginal

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