title: [Gynecological abnormalities in patients with rectovestibular fistula].
abstract: Patients with recto vestibular fistula may have gynecological malformations that could be unnoticed at the initial examination. The aim of this paper is to demonstrate the incidence of these malformations and propose a study method to help diagnose these malformations, avoiding unnecessary surgeries. We reviewed the records of patients treated with rectovaginal fistula (RVF) in the last 18 years and studied their gynecological malformations, time at diagnosis and treatment received. Of the 39 patients treated, 5 of them (13.1%) demonstrated 9 gynecological malformations: Hemivaginas (2), hemiuteros (2), uterine agenesis (2), vaginal agenesis (2) and vaginal septum (1). The diagnosis was made after the posterior sagittal approach (PSA) in two patients (acute abdomen and hydrometrocolpos), during the PSA in 2 patients and only one of them was diagnosed before the PSA. The 2 patients with hemivaginas and hemiuterus underwent a hemihysterosalpinguectomy and a vaginoplasty later in adolescence. The patient with vaginal and uterine agenesis diagnosed prior to PSA underwent a posterior sagittal anorectoplasty and a vaginoplasty with colon in the same procedure. The patient with vaginal and uterine agenesis (age 13 months) is waiting for vaginal replacement. The patient with vaginal septum (intraoperative finding) underwent a septum resection during the PSA. Gynecological defects are part of RVF spectrum. Girls with RVF require a complete gynecological examination prior to the definitive repair. Preoperative examinations assist in the timing and type of repair, and ultimately avoids complications and unnecessary interventions.
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: A
authors.initials: A
authors.lastname: Vilanova-Sánchez
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: A
authors.initials: A
authors.lastname: Sánchez Galán
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: A M
authors.initials: AM
authors.lastname: Andrés Moreno
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: J L
authors.initials: JL
authors.lastname: Encinas Hernández
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: V
authors.initials: V
authors.lastname: Núñez Cerezo
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: V
authors.initials: V
authors.lastname: Amesty Morello
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: G
authors.initials: G
authors.lastname: Chocarro Amatrianin
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: L
authors.initials: L
authors.lastname: Martínez Martínez
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: M J
authors.initials: MJ
authors.lastname: Martínez-Urruta
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: M
authors.initials: M
authors.lastname: López Santamaría
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D007223:Infant; D012006:Rectovaginal Fistula / Q000209:etiology / Q000601:surgery*; D014599:Uterus / Q000002:abnormalities* / Q000601:surgery; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery
keywords: Anorrectal malformation; Ginecologic malformation; Rectovestibular fistula; Vaginal atresia; Vaginal septum