Rectovaginal fistula after STARR procedure complicated by haematoma of the posterior vaginal wall: report of a case
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- Bassi, R., Rademacher, J. & Savoia, A. Tech Coloproctol (2006) 10: 361. doi:10.1007/s10151-006-0310-1
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We report the case of a patient treated with the stapled transanal rectal resection (STARR) procedure for obstructed defecation, who developed an early postoperative haematoma of the posterior vaginal wall and, after 30 days, a rectovaginal fistula (RVF), even though the intervention had been performed according to the standardized technique. After clinical examination and three-dimensional anal endosonography, we carried out a successful surgical correction with double vaginal and rectal flaps with repair of the rectovaginal septum and without faecal diversion. The STARR procedure, even if performed according to a rigorous application of the methodological standards, may be followed by a RVF possibly due to a blood collection leading to ischaemia of the vaginal wall.