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Non-inflammatory rectovaginal fistula

S J Watson1, R K Phillips

  • 1Department of Surgery, St Mark's Hospital, Northwick Park, Harrow, UK.

The British Journal of Surgery
|December 1, 1995
PubMed
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Surgical repair of rectovaginal fistulas yielded excellent long-term results, with 23 of 26 women cured. However, initial treatments showed high failure rates for specific surgical approaches, necessitating further investigation.

Area of Science:

  • Colorectal Surgery
  • Gynecologic Surgery
  • Fistula Treatment

Background:

  • Rectovaginal fistulas (RVFs) are abnormal connections between the rectum and vagina, often resulting from obstetric trauma, infection, or inflammatory conditions.
  • Surgical repair is the primary treatment for RVFs, aiming to restore normal anatomy and function.
  • Various surgical techniques exist, each with potential benefits and drawbacks.

Purpose of the Study:

  • To evaluate the long-term outcomes of surgical repair for straightforward rectovaginal fistulas.
  • To identify early failure rates associated with specific surgical methods.

Main Methods:

  • Retrospective analysis of 26 women undergoing surgical repair for rectovaginal fistulas.
  • Categorization of fistula etiology (obstetric, infection, trauma, unknown).

Related Experiment Videos

  • Assessment of surgical techniques including transanal advancement flap and perineoproctotomy (lay open and repair).

    • Main Results:

    • Overall excellent long-term results were achieved, with 23 out of 26 patients (88.5%) cured.
    • A high early failure rate was observed in 5 of 12 patients (41.7%) undergoing transanal advancement flap repair.
    • One of 8 patients (12.5%) undergoing perineoproctotomy experienced early failure.
    • Temporary stomas were utilized in 11 patients (42.3%) due to complications or complexity.

    Conclusions:

    • While surgical repair of rectovaginal fistulas offers excellent long-term success, specific techniques like the transanal advancement flap may have significant early failure rates.
    • Perineoproctotomy also demonstrated an early failure rate, though lower than the advancement flap.
    • The high rate of temporary stoma use indicates the complexity and potential challenges in managing these fistulas.