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Erschienen in: International Urogynecology Journal 6/2016

17.10.2015 | Clinical Opinion

Presentation and management of rectovaginal fistulas after delivery

verfasst von: Christl Reisenauer

Erschienen in: International Urogynecology Journal | Ausgabe 6/2016

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Abstract

Introduction

Obstetric trauma leading to rectovaginal fistula (RVF) formation results from perineal laceration and/or from prolonged ischemia and necrosis following obstructed labor. Due to modern obstetric care fistulas are rare in industrialized countries.

Methods

Patients undergoing surgery for a RVF between January 2005 and December 2014 at the Department of Obstetrics and Gynecology, Tuebingen, Germany, were identified and their records were reviewed retrospectively.

Results

Of 48 patients, 13 developed RVF of obstetric etiology. Parity ranged from 2 to 4. RVF repair was performed in all patients using a transvaginal approach: fistula excision and multilayer closure (7 of 13) with Martius flap interposition (1 of 7) and sphincteroplasty (5 of 13). One RVF closed spontaneously. Due to significant destruction of the anal canal, large RVF and RVF recurrence, 4 of the 13 patients needed a temporary protective ileostomy. Fistula closure was achieved in 12 of 13 patients.

Conclusion

The choice of RVF repair should be tailored to the underlying pathology and type of repair done previously and the patient’s wishes
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Metadaten
Titel
Presentation and management of rectovaginal fistulas after delivery
verfasst von
Christl Reisenauer
Publikationsdatum
17.10.2015
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 6/2016
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-015-2860-0

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