title: [Les fistules recto-vaginales d'origine obstétricale: aspects épidémiologiques et approaches thérapeutiques. Etude multicentrique tunisienne].
abstract: BACKGROUND
  Rectovaginal fistulas are abnormal epithelial-lined connections between the rectum and vagina. The aquired etiology caused by child birth are still frequent in many countries.
  
  
  OBJECTIVE
  to describe epidemiology of obstetrical recto vaginal fistula in our country and discuss therapeutic modalities Materiel and methods: A retrospective multicentric study among 19 hospital departments from February 1982 to January 2007 of obstetrical recto-vaginal fistulas including 41 patients.
  
  
  RESULTS
  The median diameter of the fistula was 12 mm. the treatment consist on excision of the fistula and perineal suturing in 34 cases, Advancement flaps was used in four cases, the Musset technique repair in two cases, Gracilis transposition for repair was used in one case. Forty five patients had satisfactory anatomic and functional satisfactory results. One patient had reported dyspareunia. Definitive failure was reported in four cases.
  
  
  CONCLUSIONS
  Our study suggests a regression in obstetrical RVF. However many efforts on institutional, socioeconomic and obstetrical levels have to be done in order to eradicate this pathology. Surgical treatments have good results. However prevention of this complication is the best treatment because a major handicap for women regarding socioeconomic, functional and psychological effects.
authors: Oussama
authors: O
authors: Baraket
authors: Makrem
authors: M
authors: Moussa
authors: Badis
authors: B
authors: Chennoufi
authors: Samy
authors: S
authors: Bouchouha
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D011644:Puerperal Disorders / Q000453:epidemiology / Q000209:etiology; D019651:Plastic Surgery Procedures; D012006:Rectovaginal Fistula / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D014416:Tunisia / Q000453:epidemiology