Rectovaginal fistula.
Rectovaginal fistulas present a distressing problem for the patient and a challenge for the treating physician. Successful management must take into consideration the etiology of the fistula and the health of both the rectum and the patient. Obstetrical fistulas can be treated successfully by local approaches transanally or transvaginally. Episioproctotomy may be considered if there is an associated sphincter defect. Crohn's related fistulas usually require proctectomy if the rectum is severely involved. Local repair can be considered in instances where the rectum is relatively healthy and local sepsis has been controlled. Radiation-induced fistulas may be secondary to cancer recurrence, which must be excluded. If the patient is not a candidate for a radical resectional approach, fecal diversion alone should be performed.
Saclarides
Theodore J
TJ
Rush Medical College, Rush University, 600 South Paulina Street, Chicago, IL 60612, USA. Theodore_Saclarides@rush.edu
D013505:Digestive System Surgical Procedures; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D012006:Rectovaginal Fistula / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D012307:Risk Factors