Clinical and functional results after tailored surgery for rectovaginal fistula


Pelviperineology 2007;26(2):78-81

Forty patients were treated for recto-vaginal fistula between 1988 and 2005. Thirty-five patients underwent surgery (sphincteroplasty= 12, fistulectomy and layered closure=10, advancement flap=5, diversion only=2, coloanal=2, fistulotomy=1, omentoplasty=1, ileal resection= 1, Martius graft=1). Of the 33 patients who underwent fistula repair 25 (76%) healed. Two patients healed after a second procedure, therefore final healing occurred in 27 (82%). Preoperative incontinence improved in 5/7 (71%) patients while 4/32 (12%) patients developed postoperative incontinence. There was no predictor of healing or incontinence. Choice of the appropriate treatment with selective use of sphincters and levators for reconstruction of the rectovaginal septum are likely to be relevant for successful outcome.

Keywords: Recto-vaginal fistula; Sphincteroplasty; Fistulectomy; Advancement flap.