[Management of the rectovaginal fistula. A review of five years at the Colon and Rectal Unit of the General Hospital of Mexico City].
BACKGROUND
Rectovaginal fistula, although infrequent, produces considerable discomfort to the patients and disables them in their social life.


OBJECTIVE
To review and report the experience in the management of rectovaginal fistula in the Colon and Rectal Unit of the General Hospital of Mexico City, from January 1997 to December 2001.


METHODS
A retrospective, observational and descriptive study was designed including all patients diagnosed with rectovaginal fistula, who had not been previously operated for this condition in the Colon and Rectal Unit of the General Hospital of Mexico City from January 1977 to December 2001.


RESULTS
Thirty-eight patients were included, aged between 17 and 70 years with a mean age of 24. The etiology of the rectovaginal fistulas was: obstetric trauma in 21 patients (55.2%), post-surgical in 5 (13.1%), traumatic in 5 (13.1%), after radiotherapy in 5 (13.1%) and malignant in 2 (5.2%).


CONCLUSIONS
Rectovaginal fistula treatment relies on fistula classification (simple or complex), its location, and damage or not to the sphincter mechanisms and prior surgical repair.


CONCLUSIONS
The most frequent surgical approach was the creation of a fourth degree perineum laceration and reconstruction (45.7%), followed by the advancement flap (25.7%). Complex fistulas were handled with a stoma. The surgical approach of rectovaginal fistula must rely on etiologic, anatomic and physiologic basis.
Unidad de colorpoctología, servicio de gastroenterología, Hospital General de México, OD. luischarua@hotmail.com
Luis
L
Charúa Guindic
Leopoldo
L
Retama Velasco
Octavio
O
Avendaño Espinosa
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008800:Mexico; D008875:Middle Aged; D012006:Rectovaginal Fistula / Q000601:surgery*; D012189:Retrospective Studies