title: Transvaginal repair of recurrent pouch-vaginal fistula.
abstract: OBJECTIVE
  Pouch-vaginal fistula is an uncommon but unpleasant complication. The chance of successful repair with various surgical procedures is around 50% and the early promise of collagen button plugs was not followed by good long-term results. We report a series of patients who underwent transvaginal repair of pouch-vaginal fistula after failed collagen plugs accompanied by a video to show the operative technique.
  
  
  METHODS
  Patients were identified from a prospectively maintained database. Patient demographics, operation notes, complications and ultimate outcome were recorded.
  
  
  RESULTS
  Eleven patients, each of whom had previously undergone an attempt to close the fistula with a collagen button plug, underwent transvaginal repair. Nine (81%) were successful at a median follow-up of 14 (6-56) months. The remaining two patients reported symptomatic improvement.
  
  
  CONCLUSIONS
  Pouch-vaginal fistula can be successfully closed by the transvaginal technique after a failed button plug procedure.
authors.affiliation: John Goligher Department of Colorectal Surgery, Lincoln Wing, St James's University Hospital, Leeds, UK.
authors.forename: R C
authors.initials: RC
authors.lastname: Sagar
authors.forename: M
authors.initials: M
authors.lastname: Thornton
authors.forename: A
authors.initials: A
authors.lastname: Herd
authors.forename: I
authors.initials: I
authors.lastname: Brayshaw
authors.forename: P M
authors.initials: PM
authors.lastname: Sagar
mesh_terms: D000328:Adult; D003094:Collagen / Q000627:therapeutic use; D039021:Colonic Pouches / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D008875:Middle Aged; D019233:Retreatment; D017211:Treatment Failure; D014621:Vagina; D014624:Vaginal Fistula / Q000209:etiology / Q000601:surgery* / Q000628:therapy
chemical_list: D003094:Collagen
keywords: Surgical technique; ileal pouch; outcome