Evidence map›Paper›PMID 40192869›Full record

SynthesisTechniques in coloproctology2025

Sphincter repair procedures may be favored in the treatment of obstetrical recto-vaginal fistula: a systematic review of the literature and meta-analysis.

A Venara, E Houlet, E Poupard, M André, P E Bouet, J Gillet, J F Hamel

Erratum issuedAbstract readSystematic ReviewComparative StudyNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Techniques in coloproctology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

A Venara *Faculty of Health, Department of Medicine, University of Angers, Angers, France. auvenara@chu-angers.fr.
E Houlet *Faculty of Health, Department of Medicine, University of Angers, Angers, France.
E PoupardFaculty of Health, Department of Medicine, University of Angers, Angers, France.
M AndréFaculty of Health, Department of Medicine, University of Angers, Angers, France.
P E BouetFaculty of Health, Department of Medicine, University of Angers, Angers, France.
J GilletFaculty of Health, Department of Medicine, University of Angers, Angers, France.
J F HamelFaculty of Health, Department of Medicine, University of Angers, Angers, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe management of obstetric rectovaginal fistula (RVF) is challenging for the surgeon. The best surgical procedure to repair RVFs, specifically after obstetric anal sphincter injury, has not been extensively studied. The objective was to compare the success of the different procedures performed to repair obstetric RVF.

methodsThe literature search was carried out on PubMed

resultsThe quantitative synthesis included 32 studies (18 retrospective and 14 prospective) accounting for 595 patients. The quality of these studies was low because of the lack of prospective randomization. Nineteen procedure types were described and assessed. Most patients (n = 180) underwent endorectal advancement flap (ERAF) followed by excision and layered closure (ELC) (n = 213) and Musset procedure (n = 65). A diverting stoma was performed in 66/132 patients. Only 13 studies reported the functional results of the procedure. In the meta-analysis, the Musset procedure (OR = 4.29; 95% CI: 1.18-16.14), transvaginal ELC (OR = 11.84; 95% CI: 2.18-91.80) and transperineal ELC (OR = 3.56; 95% CI: 1.26-10) significantly improved the anatomical results compared to ERAF.

conclusionsA further randomized controlled trial in the literature assessing ERAF and sphincteroplasty to compare the anatomical results, functional results and morbidity of this treatment is needed. REGISTRATION: PROSPERO CRD42023447875.

Indexed as

Anal CanalObstetric Labor ComplicationsRectovaginal FistulaFemaleHumansPregnancyRetrospective StudiesSurgical FlapsTreatment OutcomeAnovaginal fistulaObstetricRectovaginal fistulaRepair

Identifiers

PMID40192869
PMCPMC11976829

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.