[Vaginal flap for rectovaginal fistulae in Crohn's disease].
OBJECTIVE
To evaluate efficacy and functional results (sexual activity) of vaginal flap for rectovaginal fistula in Crohn's disease.


METHODS
From May 2004 to March 2008, we proposed a vaginal flap in patients who had a rectovaginal fistula in Crohn's disease and for which rectal flap was technically impossible. Monitoring included a clinical examination at 1 month and every 3 months for 1 year, Perianal Disease Activity Index for sexual activity evaluation. Every year and in April 2009 the nursing team during a telephone interview filled a standardized questionnaire.


RESULTS
We treated 5 patients. At 6 months, 4 of 5 patients were healed. At 7 months, 1 patient presented a new flare up of CD with reopening of the fistula. The other 3 patients were still healed at a median follow-up of 30.66 months (15 to 59). One patient presented dyspareunia during 3 months.


CONCLUSIONS
Vaginal flap is an effective technique that entails neither prolonged dyspareunia nor fecal incontinence. Stoma is not systematic.
Service de coloproctologie, clinique des Cèdres, Cornebarrieu, France. michel.queralto@wanadoo.fr
M
M
Queralto
W
W
Badiou
G
G
Bonnaud
L
L
Abramowitz
Y
Y
Tanguy Le Gac
X
X
Monrozies
D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000150:complications*; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008875:Middle Aged; D012006:Rectovaginal Fistula / Q000209:etiology / Q000601:surgery*; D012725:Sexual Behavior / Q000502:physiology; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D016896:Treatment Outcome