ABSTRACT
Rectovaginal fistulas represent an often devastating condition in patients and a challenge
for surgeons. Successful management of this condition must take into account a variety
of variables including the etiology, size, and location of the fistula. Etiologies
include obstetrical trauma, inflammatory bowel disease, malignant processes, and complications
of radiation therapy and surgery. Repair options include local repairs, tissue transfer
techniques, and abdominal operations.
KEYWORDS
Fistula - rectovaginal - obstetrical trauma - mucosal advancement flap
REFERENCES
- 1
Fenner D E, Genberg B, Brahma P, Marek L, DeLancey J O.
Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption
in an obstetrics unit in the United States.
Am J Obstet Gynecol.
2003;
189
1543-1549
- 2
Signorello L B, Harlow B L, Chekos A K, Repke J T.
Midline episiotomy and anal incontinence: retrospective cohort study.
BMJ.
2000;
320
86-90
- 3
Christianson L M, Bovbjerg V E, McDavitt E C, Hullfish K L.
Risk factors for perineal injury during delivery.
Am J Obstet Gynecol.
2003;
189
255-260
- 4
Hudelist G, Gelle'n J, Singer C et al..
Factors predicting severe perineal trauma during childbirth: role of forceps delivery
routinely combined with mediolateral episiotomy.
Am J Obstet Gynecol.
2005;
192
875-881
- 5
Venkatesh K S, Ramanujam P S, Larson D M, Haywood M A.
Anorectal complications of vaginal delivery.
Dis Colon Rectum.
1989;
32
1039-1041
- 6
Goldaber K G, Wendel P J, McIntire D D, Wendel Jr G D.
Post-partum perineal morbidity after fourth degree perineal repair.
Am J Obstet Gynecol.
1993;
168
489-493
- 7
Radcliffe A G, Ritchie J K, Hawley P R, Lennard-Jones J E, Northover J M.
Anovaginal and rectovaginal fistulas in Crohn's disease.
Dis Colon Rectum.
1988;
31
94-99
- 8
Schwartz D, Loftus E, Tremaine W et al..
The natural history of fistulizing Crohn's disease: a population based study.
Gastroenterology.
2000;
118
A337
- 9
Kodner I J, Mazor A, Shemesh E I, Fry R D, Fleshman J W, Birnbaum E H.
Endorectal advancement flap repair of rectovaginal and other complicated anorectal
fistulas.
Surgery.
1993;
114
682-689
- 10
Ozuner G, Hull T L, Cartmill J, Fazio V W.
Long-term analysis of the use of transanal rectal advancement flaps for complicated
anorectal/vaginal fistulas.
Dis Colon Rectum.
1996;
39
10-14
- 11
Sonoda T, Hull T, Piedmonte M R, Fazio V W.
Outcomes of primary repair of anorectal and rectovaginal fistulas using the endorectal
advancement flap.
Dis Colon Rectum.
2002;
45
1622-1628
- 12
Lowry A C, Thorson A G, Rothenberger D A, Goldberg S M.
Repair of simple rectovaginal fistulas. Influence of previous repairs.
Dis Colon Rectum.
1988;
31
676-678
- 13
Tsang C B, Madoff R D, Wong W D et al..
Anal sphincter integrity and function influences outcome in rectovaginal fistula repair.
Dis Colon Rectum.
1998;
41
1141-1146
- 14
Khanduja K S, Padmanabhan A, Kerner B A, Wise W E, Aguilar P S.
Reconstruction of rectovaginal fistula with sphincter disruption by combining rectal
mucosal advancement flap and anal sphincteroplasty.
Dis Colon Rectum.
1999;
42
1432-1437
- 15
Hull T L, Fazio V W.
Surgical approaches to low anovaginal fistula in Crohn's disease.
Am J Surg.
1997;
173
95-98
- 16
Marchesa P, Hull T L, Fazio V W.
Advancement sleeve flaps for treatment of severe perianal Crohn's disease.
Br J Surg.
1998;
85
1695-1698
- 17
Mazier W P, Senagore A J, Schiesel E C.
Operative repair of anovaginal and rectovaginal fistulas.
Dis Colon Rectum.
1995;
38
4-6
- 18
Cintron J R, Park J J, Orsay C P et al..
Repair of fistulas-in-ano using fibrin adhesive: long-term follow-up.
Dis Colon Rectum.
2000;
43
944-949
discussion 949-950
- 19
Champagne B J, O'Connor L M, Ferguson M, Orangio G R, Schertzer M E, Armstrong D N.
Efficacy of anal fistula plug in closure of cryptoglandular fistulas: long-term follow-up.
Dis Colon Rectum.
2006;
49
1817-1821
- 20
Abel M E, Chiu Y S, Russell T R, Volpe P A.
Autologous fibrin glue in the treatment of rectovaginal and complex fistulas.
Dis Colon Rectum.
1993;
36
447-449
- 21
Loungnarath R, Dietz D W, Mutch M G, Birnbaum E H, Kodner I J, Fleshman J W.
Fibrin glue treatment of complex anal fistulas has low success rate.
Dis Colon Rectum.
2004;
47
432-436
- 22
Rahman M S, Al-Suleiman S A, El-Yahia A R, Rahman J.
Surgical treatment of rectovaginal fistula of obstetric origin: a review of 15 years'
experience in a teaching hospital.
J Obstet Gynaecol.
2003;
23
607-610
- 23
Bauer J J, Sher M E, Jaffin H, Present D, Gelerent I.
Transvaginal approach for repair of rectovaginal fistulae complicating Crohn's disease.
Ann Surg.
1991;
213
151-158
- 24
Zmora O, Tulchinsky H, Gur E, Goldman G, Klausner J M, Rabau M.
Gracilis muscle transposition for fistulas between the rectum and urethra or vagina.
Dis Colon Rectum.
2006;
49
1316-1321
- 25
Tran K T, Kuijpers H C, van Nieuwenhoven E J, van Goor H, Spauwen P H.
Transposition of the rectus abdominis muscle for complicated pouch and rectal fistulas.
Dis Colon Rectum.
1999;
42
486-489
- 26
Horch R E, Gitsch G, Schultze-Seemann W.
Bilateral pedicled myocutaneous vertical rectus abdominis muscle flaps to close vesicovaginal
and pouch-vaginal fistulas with simultaneous vaginal and perineal reconstruction in
irradiated pelvic wounds.
Urology.
2002;
60
502-507
- 27
White A J, Buchsbaum H J, Blythe J G, Lifshitz S.
Use of the bulbocavernosus muscle (Martius procedure) for repair of radiation-induced
rectovaginal fistulas.
Obstet Gynecol.
1982;
60
114-118
- 28
Aartsen E J, Sindram I S.
Repair of the radiation induced rectovaginal fistulas without or with interposition
of the bulbocavernosus muscle (Martius procedure).
Eur J Surg Oncol.
1988;
14
171-177
- 29
Parks A G, Allen C L, Frank J D, McPartlin J F.
A method of treating post-irradiation rectovaginal fistulas.
Br J Surg.
1978;
65
417-421
- 30
Nowacki M P.
Ten years of experience with Parks' coloanal sleeve anastomosis for the treatment
of post-irradiation rectovaginal fistula.
Eur J Surg Oncol.
1991;
17
563-566
- 31
Cooke S A, Wellsted M D.
The radiation-damaged rectum: resection with coloanal anastomosis using the endoanal
technique.
World J Surg.
1986;
10
220-227
- 32
Bricker E M, Johnston W D.
Repair of postirradiation rectovaginal fistula and stricture.
Surg Gynecol Obstet.
1979;
148
499-506
- 33
Steichen F M, Barber H K, Loubeau J M, Iraci J C.
Bricker-Johnston sigmoid colon graft for repair of postradiation rectovaginal fistula
and stricture performed with mechanical sutures.
Dis Colon Rectum.
1992;
35
599-603
- 34
Schwenk W, Bohm B, Grundel K, Muller J.
Laparoscopic resection of high rectovaginal fistula with intracorporeal colorectal
anastomosis and omentoplasty.
Surg Endosc.
1997;
11
147-149
- 35
Pelosi III M A, Pelosi M A.
Transvaginal repair of recurrent rectovaginal fistula with laparoscopic-assisted rectovaginal
mobilization.
J Laparoendosc Adv Surg Tech A.
1997;
7
379-383
- 36
Kumaran S S, Palanivelu C, Kavalakat A J, Parthasarathi R, Neelayathatchi M.
Laparoscopic repair of high rectovaginal fistula: is it technically feasible?.
BMC Surg.
2005;
5
20
David E RivadeneiraM.D.
Division of Surgical Oncology and Colon and Rectal Surgery, Stony Brook University
Medical Center
Stony Brook NY 11794-8191
Email: drivadeneira@notes.cc.sunysb.edu