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Related Experiment Video

Updated: Apr 4, 2026

Vessel-sparing Excision and Primary Anastomosis
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Operative considerations for rectovaginal fistulas.

Kevin R Kniery1, Eric K Johnson1, Scott R Steele1

  • 1Kevin R Kniery, Eric K Johnson, Scott R Steele, Department of Surgery, Division of Colorectal Surgery, Madigan Army Medical Center, Tacoma, WA 98431, United States.

World Journal of Gastrointestinal Surgery
|September 2, 2015
PubMed
Summary

Rectovaginal fistulas (RVFs) are complex conditions requiring systematic surgical approaches for optimal outcomes. This review outlines key principles for RVF repair, emphasizing least invasive options and healthy tissue interposition to minimize recurrence.

Keywords:
Anovaginal fistulasRectovaginal fistulas

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Area of Science:

  • Gastroenterology and Surgical Science
  • Gynecologic Surgery

Background:

  • Rectovaginal fistulas (RVFs) present significant challenges for both patients and surgeons.
  • High recurrence rates, approaching 40%, underscore the complexity of RVF management.

Purpose of the Study:

  • To detail the etiology, anatomy, and pathophysiology of rectovaginal fistulas.
  • To present a systematic surgical strategy for improving RVF repair outcomes.

Main Methods:

  • A comprehensive literature review was conducted to identify current RVF repair techniques and outcomes.
  • Analysis focused on established and emerging surgical interventions.

Main Results:

  • Surgical options for RVFs include collagen plugs, endorectal advancement flaps, sphincter repairs, and colo-anal reconstruction.
  • Effective management principles involve addressing sepsis, precise anatomical identification, and employing least invasive methods first.

Conclusions:

  • A systematic approach prioritizing least invasive techniques and interposing healthy tissue is crucial for successful RVF resolution.
  • Careful adherence to these principles can minimize patient morbidity and enhance fistula repair success rates.