International Urogynecology Journal

, Volume 27, Issue 3, pp 495–497 | Cite as

Repair of a traumatic cloaca after obstetric anal sphincter injury

  • Federico SpelziniEmail author
  • Matteo Frigerio
  • Stefano Manodoro
  • Debora Verri
  • Elena Nicoli
  • Rodolfo Milani
IUJ Video


Introduction and hypothesis

Unsuccessful primary repair of fourth-degree obstetric trauma can lead to permanent communication between the rectum and the vagina, which, in association with full-thickness anal sphincter defects, is characterized by complete fecal incontinence and severe impairment of quality of life. The aim of this video is to serve as a tutorial for repair.


A 27-year-old woman who developed a full-thickness recto-vaginal defect extended from the perineum to the upper third of the vagina has been managed through layered surgical repair without flaps.


Anatomy and fecal continence have been completely restored by a follow-up of 24 months.


The procedure described in this video has been shown to be effective and safe.


Obstetric anal sphincter injury Traumatic cloaca Surgical repair 


Compliance with ethical standards


Consent was obtained from the patient for publication of this video article and any accompanying images.

Conflict of interest


Supplementary material


(MP4 93670 kb)


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Copyright information

© The International Urogynecological Association 2015

Authors and Affiliations

  • Federico Spelzini
    • 1
    Email author
  • Matteo Frigerio
    • 1
  • Stefano Manodoro
    • 1
  • Debora Verri
    • 1
  • Elena Nicoli
    • 1
  • Rodolfo Milani
    • 1
  1. 1.Università Milano Bicocca, Azienda Ospedaliera San GerardoMonzaItaly

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