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Updated: Mar 31, 2026

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Repair of a traumatic cloaca after obstetric anal sphincter injury
Federico Spelzini1, Matteo Frigerio2, Stefano Manodoro2
1Università Milano Bicocca, Azienda Ospedaliera San Gerardo, Via Pergolesi, 33-20900, Monza, MB, Italy. federico.spelzini@gmail.com.
Introduction And Hypothesis:
Unsuccessful primary repair of fourth-degree obstetric trauma can lead to permanent communication between the rectum and the vagina, which, in association with full-thickness anal sphincter defects, is characterized by complete fecal incontinence and severe impairment of quality of life. The aim of this video is to serve as a tutorial for repair.
Methods:
A 27-year-old woman who developed a full-thickness recto-vaginal defect extended from the perineum to the upper third of the vagina has been managed through layered surgical repair without flaps.
Results:
Anatomy and fecal continence have been completely restored by a follow-up of 24 months.
Conclusion:
The procedure described in this video has been shown to be effective and safe.
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