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Recurrent posttraumatic urethrovaginal fistula: a new application for ASTRA
1Cattedra di Chirurgia Pediatrica, Università G.D'Annunzio Chieti, Università degli Studi di Bologna, Italy.
Journal of Pediatric Surgery
|March 22, 2000
Summary
The anterior sagittal transrectal approach (ASTRA) successfully treated a complex urethrovaginal fistula in a teenage girl after multiple failed attempts. This surgical method offers a potential solution for perineal region anomalies.
Area of Science:
- Urology
- Pediatric Surgery
- Reconstructive Surgery
Background:
- Urethrovaginal fistulas can be challenging to treat, particularly after multiple failed surgical interventions.
- Post-traumatic urethrovaginal fistulas in young females require effective and durable treatment options.
Observation:
- A 16-year-old female presented with a recurrent post-traumatic urethrovaginal fistula after four previous surgical attempts via a vaginal approach.
- The patient underwent surgical correction using the anterior sagittal transrectal approach (ASTRA).
Findings:
- The ASTRA procedure resulted in the definitive closure of the urethrovaginal fistula.
- Two years post-surgery, the patient exhibited complete functional recovery, confirmed by voiding cystourethrogram, urodynamic, and rectal manometric tests.
Implications:
- The anterior sagittal transrectal approach (ASTRA) demonstrates efficacy as a treatment for complex urethrovaginal fistulas.
- ASTRA may be a valuable surgical option for managing developmental and acquired anomalies of the perineal region.