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Anovaginal fistulae

P J Senatore1

  • 1South Shore Medical Center, Inc., Norwell, Massachusetts.

The Surgical Clinics of North America
|December 1, 1994
PubMed
Summary
This summary is machine-generated.

Anovaginal fistulae, though uncommon, can cause disabling symptoms. Comprehensive evaluation and delayed surgical repair, considering anal canal pressures and potential underlying conditions like Crohn's disease, optimize treatment outcomes.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Anorectal Diseases

Background:

  • Anovaginal fistulae are uncommon anal fistulous diseases with potentially disabling symptoms.
  • Obstetric injury is a common cause, but other conditions can also lead to these communications.

Purpose of the Study:

  • To emphasize the importance of thorough patient evaluation before surgical correction of anovaginal fistulae.
  • To discuss optimal management strategies, including timing of surgery and consideration of underlying pathologies.

Main Methods:

  • Review of literature on anovaginal fistula management.
  • Emphasis on preoperative assessment including anal sphincter function, systemic involvement, and tissue diagnosis.
  • Consideration of inflammatory and infectious status prior to intervention.

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Main Results:

  • Surgical repair success rates are generally at least 75% when planned correctly.
  • Fistulae associated with inflammatory bowel disease, particularly anal Crohn's disease, have lower success rates.
  • Medical management can aid nonoperative healing or improve surgical outcomes.

Conclusions:

  • Complete preoperative evaluation and appropriate surgical selection are crucial for optimal results in anovaginal fistula repair.
  • Delayed surgical intervention after inflammation subsides and consideration of underlying conditions are key.
  • Fecal diversion may be necessary for complex cases such as those due to neoplasia, radiation, or inflammatory bowel disease.