Related Experiment Video
Updated: Jun 19, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
H-type rectovaginal fistula in a patient with bilateral single ectopic ureters
David C Yu1, Mathew J Grabowski, Neil R Feins
1Department of Pediatric Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
Insights
This study reports the first known case of a congenital H-type rectovaginal fistula in a patient previously treated for single ectopic bilateral ureters. Recurrence after initial fistula repair highlights the need for specific surgical techniques.
Area of Science:
- Pediatric Surgery
- Urology
- Congenital Malformations
Background:
- Congenital H-type rectovaginal fistulas are rare anorectal malformations.
- Single ectopic bilateral ureters represent uncommon urinary tract anomalies.
- The co-occurrence of these conditions is exceptionally rare.
Observation:
- A female infant presented with a congenital rectovaginal fistula.
- The fistula was diagnosed two years after surgical correction of single ectopic bilateral ureters.
- The patient experienced fistula recurrence following the initial surgical repair.
Findings:
- This case represents the first documented association between congenital H-type rectovaginal fistula and single ectopic bilateral ureters.
- Surgical repair of the rectovaginal fistula was complicated by recurrence, necessitating a second intervention.
- Standard surgical techniques involving oversewing and buttressing suture lines may be insufficient for complex cases.
Implications:
- Highlights the importance of considering associated anomalies in patients with rare congenital malformations.
- Suggests that current surgical repair methods for rectovaginal fistulas may require modification for optimal outcomes.
- Emphasizes the need for distinct, separated suture lines in the vagina and rectum during surgical correction to prevent recurrence.
Abstract:
Congenital H-type rectovaginal fistulas and single ectopic bilateral ureters are each rare malformations. We describe a baby girl with a congenital rectovaginal fistula diagnosed 2 years after correction of single ectopic bilateral ureters. To our knowledge, this is the first association of these entities. Repair of fistula was complicated by recurrence, requiring a second procedure. The recommended operation for this anomaly requires separating the suture lines on the vagina and rectum. The practice of simply oversewing and then buttressing the suture lines is probably not sufficient.
