Rectovaginal separation operation after a "cutback" procedure for anorectal anomalies

Area of Science:

• Pediatric Surgery
• Gynecologic Surgery
• Reconstructive Surgery

Background:

• The
• The
• Adolescent females previously treated for ectopic anus using the
• cutback
• procedure experience cosmetic concerns and functional issues like recurrent UTIs and vaginitis due to fecal soiling.
• This highlights the need for improved surgical techniques to address these long-term complications.

Purpose of the Study:

• To introduce and evaluate a novel rectovaginal separation procedure for correcting mild ectopic anus in female newborns.
• To assess the functional and cosmetic outcomes of this new technique in adolescent patients.

Main Methods:

• A rectovaginal separation procedure was developed, involving interposing adjacent tissues to separate the rectum from the vagina.
• The technique includes elongation of the rectal canal and utilization of perineal skin flaps for adequate ano-vaginal separation.
• Five female patients (ages 6-15) underwent the procedure with a temporary loop colostomy for perineal protection during healing.

Main Results:

• Four out of five patients demonstrated excellent long-term functional and cosmetic results at three to seven years post-surgery.
• The fifth patient, with a shorter follow-up of five months, also shows a promising excellent cosmetic outcome.

Conclusions:

• The described rectovaginal separation procedure provides superior long-term functional and cosmetic results compared to the traditional
• cutback
• procedure for ectopic anus.
• This technique effectively resolves issues of fecal soiling, recurrent UTIs, and poor cosmetic appearance in affected adolescent females.