Treatment of Anorectal Fistula in Rectovaginal Fistula of Obstetric, Cryptoglandular, or Benign and Minimally Symptomatic Origin
Clinical Scenario
This protocol addresses anorectal fistula presenting as a rectovaginal fistula arising from obstetric injury, cryptoglandular infection, or a benign and minimally symptomatic cause. Initial management considerations and the choice of operative repair depend on the underlying origin of the fistula.
Patient Population
Patients with a rectovaginal fistula of obstetric, cryptoglandular, or benign and minimally symptomatic origin. Nonoperative management is typically recommended for the initial care of obstetrical rectovaginal fistula, and may also be considered for other benign and minimally symptomatic fistulas.
Surgical Approach — Partial Overview
When operative repair is indicated, flap-based reconstruction is the primary surgical strategy for most patients. The specific technique varies according to fistula location and sphincter anatomy. Further details — including the full selection criteria, procedural sequence, and management of sphincter defects — are in the complete protocol.
Full regimen, selection algorithm, and procedural specifics available via the link below.
References
DOI: 10.1097/DCR.0000000000002473
- Nonoperative management is typically recommended for the initial care of obstetrical rectovaginal fistula and may also be considered for other benign and minimally symptomatic fistulas.
- Endorectal advancement flap with or without sphincteroplasty is the procedure of choice for most patients with a rectovaginal fistula.
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