Rectovaginal fistulography: a technique for the identification of recurrent elusive fistulas.
OBJECTIVE
The purpose of this study is to review our experience with a technique for diagnosing small rectovaginal fistulas that occasionally permit passage of air or mucus.


METHODS
During an in-office visit suspicious areas of the vagina were probed with a cone-tip catheter and injected with a contrast dye to visualize the suspected fistula tract communicating to the rectum under fluoroscopic guidance. The fistulous tracts were further isolated using a flexi-tip glide wire.


RESULTS
Five out of nine patients were found to have fistulas not diagnosed by other means. Three patients had recurrent rectovaginal fistula after a vaginal delivery, one patient was identified with a high rectovaginal fistula due to diverticular disease, and one patient had a rectovaginal fistula due to prior hemorrhoidectomy. One patient had a negative test, and the fistula that was diagnosed intraoperatively was due to underlying Crohn's disease.


CONCLUSIONS
Direct fistulography is a useful technique to visualize otherwise elusive symptomatic rectovaginal fistula tracts.
Shobeiri
S Abbas
SA
Section of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, USA. Abbas-Shobeiri@ouhsc.edu
Quiroz
Lieschen
L
Nihira
Mikio
M
D000328:Adult; D002404:Catheterization; D003287:Contrast Media; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D015641:Radiography, Interventional / Q000379:methods*; D012006:Rectovaginal Fistula / Q000000981:diagnostic imaging* / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies
D003287:Contrast Media