Related Experiment Video
Updated: Aug 23, 2026
Removal of an Intravesical Gellhorn Pessary and Staged Repair of a Residual Large Vesico-Vaginal Fistula
Published on: April 14, 2026
Rectovaginal radiation fistula repair using an obturator fasciocutaneous thigh flap
Raphael C Lee1, Jacob Rotmensch
1Section of Plastic Surgery, Department of Surgery, The University of Chicago, 5812 South Ellis Avenue, Chicago, IL 60637, USA. rlee@surgery.bsd.uchicago.edu
Background:
Rectovaginal fistulae are a known complication of pelvic radiotherapy utilizing locally applied isotope implants. Most often, either permanent colostomy or reconstruction with a well-vascularized flap is necessary. Traditional techniques for fistula repair utilize bulky muscle flaps, disfiguring pudendal artery flaps or may require laparotomy.
Case:
We describe the management of a 26-year-old woman with a large radiation-induced rectovaginal fistula. A fasciocutaneous medial thigh flap based on terminal branches of the obturator artery and vein was used without colostomy and resulted in pain-free sexual function and minimal vulva disfigurement.
Conclusion:
A medial thigh fasciocutaneous flap without muscle can be transferred into the vagina on the obturator vessels and may become the preferred method for managing large rectovaginal fistulas.
