Rectovaginal Fistula in Crohn's Disease: When and How to Operate?

Jeremy Meyer; Frédéric Ris; Miles Parkes; Justin Davies

doi:10.1055/s-0041-1740029

Clinics in Colon and Rectal Surgery, Table of Contents

Clin Colon Rectal Surg 2022; 35(01): 010-020
DOI: 10.1055/s-0041-1740029

Review Article

Rectovaginal Fistula in Crohn's Disease: When and How to Operate?

Jeremy Meyer

¹Division of Digestive Surgery, University Hospitals of Geneva, Geneva, Switzerland

²Medical School, University of Geneva, Genève, Switzerland

,

Frédéric Ris

¹Division of Digestive Surgery, University Hospitals of Geneva, Geneva, Switzerland

²Medical School, University of Geneva, Genève, Switzerland

,

Miles Parkes

³Division of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom

,

Justin Davies

⁴Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom

› Author Affiliations

Abstract

Rectovaginal fistula (RVF) occurring during the course of Crohn's disease (CD) constitutes a therapeutic challenge and is characterized by a high rate of recurrence. To optimize the outcome of CD-related RVF repair, the best conditions for correct healing should be obtained. Remission of CD should be achieved with no active proctitis, the perianal CD activity should be minimized, and local septic complications should be controlled. The objective of surgical repair is to close the fistula tract with minimal recurrence and functional disturbance. Several therapeutic strategies exist and the approach should be tailored to the anatomy of the RVF and the quality of the local supporting tissues. Herein, we review the medical and surgical management of CD-related RVF.

Keywords

inflammatory bowel disease - IBD - fistula - fistulizing - vagina - rectum - rectal - complication - reconstruction - flap - mesh - prosthesis - emerging therapies

Full Text

References

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