Observational studyTechniques in coloproctology2026
Clinical outcomes of transvaginal fistulectomy and internal orifice closure in rectovaginal fistulas secondary to stapled prolapsectomy: a monocentric case series.
Observational study in Techniques in coloproctology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRectovaginal fistula (RVF) is a rare but severe complication of stapled prolapsectomy (SP), resulting from inadvertent inclusion of the posterior vaginal wall within the stapler line. RVFs secondary to SP represent a distinct iatrogenic subtype, characterized by a short, low-lying fistulous tract and localized ischemic tissue damage. We evaluated the feasibility and outcomes of a transvaginal repair strategy consisting of inverse T-shaped colpotomy, transvaginal fistulectomy, closure of the rectal defect from the vaginal side, and layered reconstruction without fecal diversion in patients with early RVF after SP.
methodsThis monocentric, retrospective observational study included adult female patients treated for RVF secondary to SP between January 2023 and April 2025. All patients underwent transvaginal fistulectomy with internal orifice closure without protective stoma. Demographic data, fistula characteristics, operative details, postoperative outcomes, and healing at 6 and 12 months were analyzed.
resultsFour consecutive patients were included. Median age was 60 years (range 54-74), and median BMI was 23.5 kg/m
conclusionsTransvaginal fistulectomy with internal orifice closure without fecal diversion could be a safe and effective surgical option for RVF secondary to SP. Given the limitations of this small retrospective single-cohort series, these findings should be considered preliminary.
trial registrationNumber CET 371-2025, date of registration 12/11/2025, retrospectively registered.
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