Operative repair of anovaginal and rectovaginal fistulas

W. Patrick Mazier, Anthony J. Senagore, Elaine C. Schiesel

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

PURPOSE: Operative repair of low rectovaginal fistulas should be tailored to the specific anatomic defect. Endoanal flap repair frequently provides successful fistula closure; however, if substantial injury to the perineal body, anal sphincter, or rectovaginal septum exists, a more extensive repair is required. We present our experience with 95 consecutive patients, operated for rectovaginal fistulasviaseptal repair after conversion to a fourth degree perineal laceration, endoanal flap, or anoperineorrhaphy. METHODS: A retrospective chart review was performed. Data collected included etiology, location, size, repair type, and degree of anal continence. All patients received standard mechanical and antibiotic bowel preparation and parenteral antibiotics. No covering stomas were used. RESULTS: Fistula etiology included obstetric injury (N=77), perianal cryptoglandular infection (N=15), and other (N=3). Thirty-one patients had previous unsuccessful repairs. Types of repairs were fourth degree perineal laceration (38), endoanal flap (19), and anoperineorrhaphy (38). Excellent or good functional results occurred in 92 patients (97 percent). Similar success occurred in patients with previous failed repairs (90 percent excellent or good). The recurrence rate was 3 percent. There were no outcome differences between techniques. CONCLUSION: We believe that all three types of repair for rectovaginal fistulas result in a high cure rate, thereby allowing operative technique to be tailored to the anatomic defects present. This approach should allow for optimal functional outcome.

Original languageEnglish (US)
Pages (from-to)4-6
Number of pages3
JournalDiseases of the Colon & Rectum
Volume38
Issue number1
DOIs
StatePublished - Jan 1995
Externally publishedYes

Keywords

  • Fistula
  • Fistula repair
  • Rectovaginal
  • Surgery

ASJC Scopus subject areas

  • Gastroenterology

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