Spontaneous rectovaginal fistula and repair using bulbocavernosus muscle flap

Abstract

Spontaneous fistula between anorectum and vagina is extremely uncommon. Successful repair depends on etiology, location and the expertise of the surgeon. We report two cases of spontaneous stercoral perforation resulting in rectovaginal fistula (RVF). Both occurred in bedridden patients with fecal impaction. One patient was successfully repaired with a bulbocavernosus (BC) flap interposition. Flap interposition prevents vaginal stenosis in repair of multiple RVF.

Benign rectovaginal fistulas: management and results of a personal series

“…Also, there is no scientific evidence that a cutting seton alone is a curative technique; moreover, it may induce incontinence. Other local repairs using a mesh [16], a cutaneous flap [17], a cadaveric dermal allograft [18], or the bulbocavernosus muscle [19] have been used in isolated or a small number of cases, so that no practical conclusions can be drawn.…”

Minimally invasive treatment of rectovaginal fistula

“…Obstetric injury is the most common cause, occurring in up to 70-88% of cases [2,4]. Other causes include rectal anterior resections (0.9-2.9%) [2] or vaginal surgery, perianal or Bartholin's gland infection, radiation proctitis, and inflammatory bowel disease [3].…”

Transanal endoscopic microsurgical treatment of rectovaginal fistula: an original technique

“…Obstetric injury is the most common cause, occurring in up to 70-88% of cases (2,3,6,8). Other causes include rectal anterior resections (0.9-2.9%) (2-4) or vaginal surgery, perianal or Bartholin's gland infection, radiation proctitis, and inflammatory bowel disease (7).…”