Evaluation and management of rectovaginal fistula in anorectal malformation: an observational study
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In brief
In brief
Retrospective 10-year study of 56 patients with rectovaginal fistula in anorectal malformation shows median presentation age of 13.48 months with 66% having associated anomalies. Surgical management included PSARP, ASARP, and abdominoperineal pull-through with constipation as the most common long-term complication, emphasizing need for specialized care and extended follow-up.
Written by the GCMD Library team from the article.
Abstract
Purpose
The rectovaginal fistula (RVF) is a type of female ARM in which the rectum terminates in the vagina. Due to its rarity, there are limited reports on its presentation, management, and follow-up. This paper deals with the clinical presentation, management, and outcome of RVF.
Methods
It was a retrospective cohort study of 10 years. The patients were evaluated for age, clinical presentation, associated anomalies, any prior surgical interventions performed elsewhere, and complications. After workup, the patients underwent three stages of surgery.
Results
Fifty-six patients of RVF were managed. The median age was 13.48 months. The associated anomalies were present in 37 (66%) patients. Posterosagittal and anterosagittal anorectoplasty (PSARP and ASARP) were performed in 29 and 6 patients, respectively. Abdominoperineal pull-through (APPT) was performed in 16 patients of congenital pouch colon. The complications of the first stage included stomal stenosis (4) and stomal prolapse (3). Constipation was present in 39 patients 2 years after the third surgery.
Conclusions
RVF is a distinct entity, which needs careful clinical examination. With proper planning for diagnosis and treatment, it can be managed at specialized centers. Care may be needed for the associated anomalies. The follow-up is an integral part of its management.