Internal Pudendal Artery Perforator Island Flap for Management of Recurrent Benign Rectovaginal Fistula.
The management of recurrent rectovaginal fistula after obstetric injury and cryptoglandular sepsis is considered a major surgical challenge. The fistula poses a significant negative psychosocial and sexual morbidity. In addition, the poor quality of local tissues due to previous attempts at surgical repair adds to this challenge. There are few data regarding the management of persistent or recurrent fistula in the literature; however, several studies reported high failure rates after 2 or more procedures. We present 4 cases managed successfully in a multidisciplinary approach involving fistulectomy and immediate reconstruction with an internal pudendal artery perforator island flap.
Department of Oncoplasty and Reconstructive Surgery, Good Hope Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom; and Department of Colorectal Surgery, Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom.
Haitham H
HH
Khalil
Department of Oncoplasty and Reconstructive Surgery, Good Hope Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom; and Department of Colorectal Surgery, Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom.
Marco N
MN
Malahias
Department of Oncoplasty and Reconstructive Surgery, Good Hope Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom; and Department of Colorectal Surgery, Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom.
Sharad
S
Karandikar
Department of Oncoplasty and Reconstructive Surgery, Good Hope Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom; and Department of Colorectal Surgery, Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom.
Charles
C
Hendrickse