Interposition of vital bulbocavernosus graft in the treatment of both simple and recurrent rectovaginal fistulas

Cui, Long; Chen, Fan; Chen, Wei; Jiang, Honghua

doi:10.1007/s00384-009-0720-4

Cited by 30 publications

(14 citation statements)

References 17 publications

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“…[22] who reported 11 patients with inflammatory bowel disease. Despite previous attempts at repair, including vaginal or rectal advancement flap procedures, the Martius graft was associated with low morbidity as had been found by others [23]. .…”

Section: Discussionmentioning

confidence: 99%

Martius advancement flap for low rectovaginal fistula: short- and long-term results

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Martius advancement flap for low rectovaginal fistula: short- and long-term results

et al. 2011

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“…Approach for local repair may be endorectal, trans vaginal or trans perineal. Various tissue options available for interposition include omental flap, gracilis flap, adipose tissue from labia majora [7], bulbocavernosus [8], pubococygeus [9] and gracilis muscle [10]. Direct local repair though attractive because of its minimally invasive nature is often unsuccessful since anovaginal septum is a thin, poorly vascularized structure with successful healing reported in 66.7 % cases [6].…”

Section: Discussionmentioning

confidence: 99%

Rectovaginal Fistula with Anastomotic Stricture Post Anterior Resection – Sphincter Preservation, a Viable Option

Pai

Desouza

Menezes

et al. 2015

Indian J Surg Oncol

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Rectovaginal fistula [RVF] is a devastating complication of anterior resection whose incidence worldwide is on a rise with widespread use of staplers for the rectal anastomosis. It is a special surgical challenge for the treating surgeon with limited suitable options available to treat this difficult situation. As there is no consensus on its management, most often patient ends up with permanent stoma and overall inferior quality of life. We are presenting a case of post anterior resection RVF which was treated with intersphincteric resection followed by hand sewn coloanal anastomosis. An intersphincteric resection avoids dissection in a previously violated rectovaginal plane and improves chances of sphincter preservation. A well vascularized colonic graft with hand sewn coloanal anastomoses well below the site of fistula and omental interposition further avoids the chances of recurrence of fistula.

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“…This goal can be achieved with an omental flap in combination with fistula closure 17 , as well as through the trans-perineal approach. In the latter the reconstruction of the rectovaginal space is performed by a pedicled flap of adipose tissue from the labia majora (Martius procedure) 18 , the bulbocavernosus muscle 19 , or the gracilis muscle 20,21 .…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic rectovaginal fistula repair by trans-perineal approach and pubo-coccygeus muscle interposition

Pata

Pasini

Roncali

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONRectovaginal fistula (RVF) is a rare but debilitating complication of a variety of pelvic surgical procedures.PRESENTATION OF CASEWe report the case of a 45-year-old female who underwent the STARR (Stapled Trans Anal Rectal Resection) procedure, that was complicated by a 30mm rectovaginal fistula (RVF). We successfully repaired the fistula by trans-perineal approach and pubo-coccygeus muscle interposition. Seven months later we can confirm the complete fistula healing and good patient's quality of life. We carefully describe our technique showing the advantages over alternative suturing, flap reconstruction or resection procedures.DISCUSSIONThis technique is fairly easy to perform and conservative. The pubo-coccygeus muscle is quickly recognizable during the dissection of the recto-vaginal space and the tension-free approximation of this muscle by single sutures represents an easy way of replacement of the recto-vaginal septum.CONCLUSIONIn our experience the use of pubo-coccygeus muscle interposition is an effective technique for rectovaginal space reconstruction and it should be considered as a viable solution for RVF repair.

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Interposition of vital bulbocavernosus graft in the treatment of both simple and recurrent rectovaginal fistulas

Abstract: Both simple and complex rectovaginal fistula can be reliably repaired using a bulbocavernosus graft.

Cited by 30 publications

References 17 publications

Martius advancement flap for low rectovaginal fistula: short- and long-term results

Martius advancement flap for low rectovaginal fistula: short- and long-term results

Rectovaginal Fistula with Anastomotic Stricture Post Anterior Resection – Sphincter Preservation, a Viable Option

Iatrogenic rectovaginal fistula repair by trans-perineal approach and pubo-coccygeus muscle interposition

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