Recto-vaginal fistulas: A case series

Ziouziou, Imad; Ammouri, Safaa; Ouazni, Mohammed; Sumba, Harrison; Koutani, Abdellatif; Andaloussi, Ahmed Iben Attya

doi:10.1016/j.ijscr.2020.05.059

Cited by 7 publications

(9 citation statements)

References 33 publications

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“…The mechanism of injury in obstetric fistula is pressure necrosis following prolonged obstructed labour, obstetric manoeuvres in precipitous delivery, and sometimes following elective abortions [3,4]. In the developed world, obstetric VVF and RVF are rare now, and in most cases, these fistulae are due to pelvic surgery, malignancy, radiotherapy, or a combination of the above factors [2][3][4]7].…”

Section: Discussionmentioning

confidence: 99%

Two Decadal Experiences in Managing Combined Obstetric Vesicovaginal and Rectovaginal Fistulas: A Study From Northern Indian Tertiary Hospital

Singh¹,

Pandey²,

Yadav³

et al. 2023

Cureus

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Introduction: A retrospective study of 28 patients with obstetric combined vesicovaginal fistula (VVF) and rectovaginal fistula (RVF) treated at our centre throughout the last two decades (2002 to 2022) has been conducted.Material and method: In 12 patients, a preoperative diverting colostomy was performed. Six patients had single-stage surgery (both VVF and RVF repair in the same operation) of which two cases required transabdominal repair and four required transvaginal repair.Result: All single-stage repairs (n=6) were successful in curing urine and faecal incontinence. In 22 patients, VVF was corrected initially via the transvaginal method with Martius flap interposition, followed by RVF repair three months later. In 2/22 patients, there was a leak after RVF repair; therefore, proximal diverting colostomy was performed, and RVF repair was repeated after six months.Conclusion: All cases had effective VVF and RVF repairs, and both urine and faecal incontinence were completely cured. This study suggests the collaborative engagement of a urologist and a surgical gastroenterologist results in an advantageous outcome for the surgical treatment of these intricate obstetric fistulas.

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Section: Discussionmentioning

confidence: 99%

Two Decadal Experiences in Managing Combined Obstetric Vesicovaginal and Rectovaginal Fistulas: A Study From Northern Indian Tertiary Hospital

Singh¹,

Pandey²,

Yadav³

et al. 2023

Cureus

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“…The perineal approach is preferred in cases of RVF below the sphincter complex. Repair options include a flap repair of the anterior rectum and a mucosal flap with or without anal sphincterplasty [ 10 ]. The Martius fat pad flap uses a vascularized adipose tissue flap from the labium majus, which divides the vaginal and rectal layers and improves wound healing by enhancing blood supply through neovascularization [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Martius fat pad flap procedure for management of obstetric rectovaginal fistula: A case report

Hadi,

Hardianto,

Kurniawati

et al. 2023

Case Reports in Women's Health

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“…PH-RVF is invariably a high recto-vaginal fistula that has a distinct etiopathogenesis, clinical course, and management considerations compared to those resulting from other etiologies. The available literature on PH-RVF is sparse (Table 4) [3,[5][6][7][8][9][10][11][12]. The current study specifically addresses this subgroup.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the data available addressing the problem of post-hysterectomy recto-vaginal fistula (PH-RVF) specifically comes from case reports [3,5,6]. The larger series on recto-vaginal fistula in general does not provide clear information on the management of PH-RVF [7][8][9][10][11][12]. The purpose of this study was to assess the clinical presentation, work-up, management, and outcomes of PH-RVF.…”

Section: Introductionmentioning

confidence: 99%

Post-Hysterectomy Rectovaginal Fistula: A Series of Five Cases

Givvimani¹,

Nachiappan²

2022

SCR

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Background: Post-hysterectomy recto-vaginal fistula (PH-RVF) is a condition where abnormal communication develops between the healing vaginal vault and the rectum secondary to an iatrogenic surgical insult. The purpose of this study was to evaluate the clinical presentation, work-up, management, and outcomes of patients with PH-RVF. Methods: Patients who underwent repair from January 2006 to December 2020 were analysed. The data was obtained retrospectively from a prospectively maintained database. Results: Five patients formed part of the study. All patients presented with faecal peritonitis required a faecal diversion. The mean distance of the fistula was 9.4 cm from the anal verge. Multi-detector CT with rectal contrast delineated the fistula in all. There were no associated fistulae. Laparoscopic repair was undertaken at a median of 12 weeks after faecal diversion. The average blood loss and mean operative time were 66 mL and 176 minutes, respectively. Tissue interposition was done in three patients. There was no major morbidity. The median hospital stay was five days. Four patients had successful repairs. A recurrence was managed with a laparotomy, fistula takedown, and rectus abdominis interposition. Bowel continuity was restored 10 weeks (mean duration) after definitive repair. At a median follow-up of 114 months, none had vaginal discharge, urinary tract infections, or complaints regarding sexual function. Conclusion: PH-RVF, a particular subset of high recto-vaginal fistula, is a complex fistula. Faecal diversion is required early in the course of management. With adequate planning, laparoscopic primary closure with or without tissue buttress is feasible, safe, and has a favourable long-term outcome.

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Recto-vaginal fistulas: A case series

Cited by 7 publications

References 33 publications

Two Decadal Experiences in Managing Combined Obstetric Vesicovaginal and Rectovaginal Fistulas: A Study From Northern Indian Tertiary Hospital

Two Decadal Experiences in Managing Combined Obstetric Vesicovaginal and Rectovaginal Fistulas: A Study From Northern Indian Tertiary Hospital

Martius fat pad flap procedure for management of obstetric rectovaginal fistula: A case report

Post-Hysterectomy Rectovaginal Fistula: A Series of Five Cases

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