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Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
Published on: September 13, 2022
Extrasphincteric perianal fistulae after sacrospinous fixation for apical prolapse
Adam Gafni-Kane1, Roger P Goldberg, James S Spitz
1From the Evanston Continence Center, Department of Obstetrics and Gynecology, Division of Urogynecology, and the Department of General Surgery, Division of Colorectal Surgery, NorthShore University Healthsystem, University of Chicago Pritzker School of Medicine, Evanston, Illinois.
Background:
Delayed extrasphincteric perianal fistulae may be encountered after sacrospinous vaginal vault suspension or hysteropexy with permanent sutures.
Cases:
We report two cases of extrasphincteric perianal fistulae: one after a sacrospinous vaginal vault suspension and one after a sacropsinous hysteropexy. Reproduction of the vaginal dissection performed to place the sacrospinous fixation sutures failed to expose the sutures, and the fistulae persisted. Perianal fistulotomy and fistulectomy, however, resulted in identification and excision of the sutures.
Conclusion:
Perianal fistulotomy or fistulectomy offers the most successful approach to identifying the inciting sutures.
