Recurrent Obstetric Rectovaginal Fistula Treated By Acellular Interposition Graft. A Case Report
Journal Title: PARIPEX-Indian Journal of Research - Year 2015, Vol 4, Issue 3
Abstract
Obstetrical trauma is the most common cause of rectovaginal fistulas. Although having a low incidence (0.5-1% of vaginal births), rectovaginal fistulas produce devastating effects on women’s quality of life.We present the Romanian experience in treating recurrent rectovaginal fistulas using the technique of interposing acellular biological second generation Surgisis tissue graft. We report the case of a 33 years old patient who delivered vaginallya3200 grams weighing newborn10 years before,after a precipitate labor for which an episiotomy was performed, followed by the appearance of a rectovaginal fistula with numerous attempts of reconstruction. Following biological graft interposition the rectovaginal fistula was cured.In this case with multiple treatment attempts that led to major alterations in the vulvo-ano-perineal region we used the technique of episyoproctotomy with sphincter reconstruction and interposition of acellular tissue graft. Favorable postoperative course proved the method’s efficacy in this patient.Recurrent rectovaginal fistulas associated with sphincter muscle lesions can be approached by episyoproctotomy technique, which allows the reconstruction of the ano-perineal region. Surgisis Bio Design biological graft interposition is an alternative that can solve recurrent rectovaginal fistulas.
Authors and Affiliations
BRATILAE LVIRA, BRATILA CORNEL PETRE, COMANDASU DIANA- ELENA
Keywords
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