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Pata G, Pasini M, Roncali S, et al. Iatrogenic rectovaginal fistula repair by trans-perineal approach and pubo-coccygeus muscle interposition. Int J Surg Case Rep. 2014;5(8):527-31doi: 10.1016/j.ijscr.2014.04.014.
Pata, G., Pasini, M., Roncali, S., Tognali, D., & Ragni, F. (2014). Iatrogenic rectovaginal fistula repair by trans-perineal approach and pubo-coccygeus muscle interposition. International journal of surgery case reports, 5(8), 527-31. https://doi.org/10.1016/j.ijscr.2014.04.014
Pata, Giacomo, et al. "Iatrogenic rectovaginal fistula repair by trans-perineal approach and pubo-coccygeus muscle interposition." International journal of surgery case reports vol. 5,8 (2014): 527-31. doi: https://doi.org/10.1016/j.ijscr.2014.04.014
Pata G, Pasini M, Roncali S, Tognali D, Ragni F. Iatrogenic rectovaginal fistula repair by trans-perineal approach and pubo-coccygeus muscle interposition. Int J Surg Case Rep. 2014;5(8):527-31. doi: 10.1016/j.ijscr.2014.04.014. Epub 2014 Jun 19. PMID: 25016079; PMCID: PMC4147571.
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Int J Surg Case Rep. 2014;5(8):527-31. doi: 10.1016/j.ijscr.2014.04.014. Epub 2014 Jun 19.

Iatrogenic rectovaginal fistula repair by trans-perineal approach and pubo-coccygeus muscle interposition.

International journal of surgery case reports

Giacomo Pata, Mario Pasini, Stefano Roncali, Daniela Tognali, Fulvio Ragni

Affiliations

  1. Department of Medical & Surgical Sciences, 2nd Division of General Surgery, Brescia Civic Hospital, Brescia, Italy. Electronic address: [email protected].
  2. Department of Medical & Surgical Sciences, 2nd Division of General Surgery, Brescia Civic Hospital, Brescia, Italy.
  3. Department of Medical & Surgical Sciences, 2nd Division of General Surgery, University of Brescia School of Medicine, Brescia, Italy.

PMID: 25016079 PMCID: PMC4147571 DOI: 10.1016/j.ijscr.2014.04.014

Abstract

INTRODUCTION: Rectovaginal fistula (RVF) is a rare but debilitating complication of a variety of pelvic surgical procedures.

PRESENTATION OF CASE: We report the case of a 45-year-old female who underwent the STARR (Stapled Trans Anal Rectal Resection) procedure, that was complicated by a 30mm rectovaginal fistula (RVF). We successfully repaired the fistula by trans-perineal approach and pubo-coccygeus muscle interposition. Seven months later we can confirm the complete fistula healing and good patient's quality of life. We carefully describe our technique showing the advantages over alternative suturing, flap reconstruction or resection procedures.

DISCUSSION: This technique is fairly easy to perform and conservative. The pubo-coccygeus muscle is quickly recognizable during the dissection of the recto-vaginal space and the tension-free approximation of this muscle by single sutures represents an easy way of replacement of the recto-vaginal septum.

CONCLUSION: In our experience the use of pubo-coccygeus muscle interposition is an effective technique for rectovaginal space reconstruction and it should be considered as a viable solution for RVF repair.

Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Pubo-coccygeus muscle; Rectovaginal fistula repair; STARR; TRANSTAR

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