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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
1   Division of Digestive Surgery, University Hospitals of Geneva, Geneva, Switzerland
2   Medical School, University of Geneva, Genève, Switzerland
,
Frédéric Ris
1   Division of Digestive Surgery, University Hospitals of Geneva, Geneva, Switzerland
2   Medical School, University of Geneva, Genève, Switzerland
,
Miles Parkes
3   Division of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
,
Justin Davies
4   Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
› Author Affiliations Funding None.
› Further Information
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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


Publication History

Article published online:
17 January 2022

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