ArticleTechniques in coloproctology2021
What is the best method of rectovaginal fistula repair? A 25-year single-center experience.
Article in Techniques in coloproctology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 20 citations in OpenAlex.
- Long-term results of the Musset surgical technique in the treatment of recto-vaginal fistulas.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Surgical Outcomes in Laparoscopic vs Open Diverting Colostomy for Radiation-Related Rectovaginal Fistula.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Article
- Gangrene Secondary to Perineal Invasion by Rectal Cancer: A Case Report and Literature Review.Cureus · 2024Article
- [Rectovaginal fistulas : Differentiated diagnostics and treatment].Chirurgie (Heidelberg, Germany) · 2024Review
- What is the best surgical option after failure of graciloplasty in patients with recurrent rectovaginal fistula? A study of 19 consecutive patients.Techniques in coloproctology · 2023Article
- Long-Term Outcomes of Surgery for Rectovaginal Fistula in 100 Consecutive Patients at a Tertiary Center.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Gracilis muscle transposition in complex anorectal fistulas of diverse types and etiologies: long-term results of 60 cases.International journal of colorectal disease · 2023Article
- Treatment of Rectovaginal Fistula.Journal of the anus, rectum and colon · 2023Review
- Transvaginal approach for rectovaginal fistula: experience from a single institution.Updates in surgery · 2022Article
- Ano-rectovaginal fistula after obstetrical anal sphincter injury: Diverting stoma does not improve the surgical results.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2022Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe surgical treatment of rectovaginal fistula (RVF) remains challenging and there is a lack of data to demonstrate the best, single procedure. The aim of this study was to assess the results of different surgical operations for rectovaginal fistula.
methodsPatients with RVF who underwent surgical repair between 1992 and 2017 at a single, tertiary care center were included. Twenty different procedures were performed including: primary closure, closure with sphincter repair, flap repairs, plug/fibrin/mesh repair, examination under anesthesia (EUA) ± seton placement, abdominal resections with and without diversion and ileostomy takedown, gracilis muscle transposition, fistulotomy/ligation of intersphincteric fistula tract. All patients with RVF due to diverticulitis and patients without complete data from paper charting were excluded. Success was defined based on the absence of symptoms related to RVF and absence of diverting stoma at 6 months.
resultsOne hundred twenty-four women were analyzed. The median age was 45 (range 18-84) years. Median follow-up time from the last procedure was 6 months (range 0-203 months). The total number of patients considered successfully treated at the end of their treatment was 91 (91/124, 73.4%). When considering all procedures (n = 255), the success rate for flap procedures was 57.9% (22/38), followed by abdominal resections with and without proximal diversion and ileostomy takedown (16/29, 55.2%) and primary closure with sphincter repair (17/32, 53.1%) while fistula plug, and fibrin glue had among the lowest success rates (4/22, 18.2%). The highest success rate was observed among patients whose RVF etiology was due to malignancy (11/16, 68.8%) followed by unknown (8/14, 57%) and iatrogenic (21/48, 43.8%) causes.
conclusionsLocal procedures such as mucosal flap or primary closure and sphincteroplasty are associated with a high success rate should be considered in patients with low-lying, simple RVF. Abdominal resections with and without proximal diversions and ileostomy takedown have a relatively high success rate in selected patients. The low success rate of fibrin glue and fistula plugs demonstrates their low efficacy in RVF; thus, these procedures should be avoided in the treatment algorithm.
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