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Surgical therapy for rectovaginal fistulas in ulcerative colitis

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  • Published:
Diseases of the Colon & Rectum

Abstract

During a 9-year period, six women with ulcerative colitis (UC) and rectovaginal fistulas were surgically treated. Three underwent ileoanal pull-through procedures with simultaneous repair of the rectovaginal fistulas. Two patients had Kock pouches, and one had a Brooke ileostomy because extensive destruction of the rectal sphincter prohibited ileoanal procedures. The three patients who had ileoanal procedures all had excellent functional results. There has been no evidence of Crohn's disease or fistula recurrence. We believe that rectovaginal fistulas occur more frequently in UC than is generally accepted, and they can be safely managed with current reconstructive techniques.

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References

  1. Bandy LC, Addison A, Parker RT. Surgical management of rectovaginal fistulas in Crohn's disease. Am J Obstet Gynecol 1983;147:359–63.

    PubMed  Google Scholar 

  2. Lescher TC, Pratt JH. Vaginal repair of the simple rectovaginal fistula. Surg Gynecol Obstet 1967;124:1317–21.

    PubMed  Google Scholar 

  3. Given FT Jr. Rectovaginal fistula: a review of 20 years' experience in a community hospital. Am J Obstet Gynecol 1970;108:41–6.

    PubMed  Google Scholar 

  4. Corman ML. Colon and rectal surgery. 2nd ed. Philadelphia: Lippincott, 1989.

    Google Scholar 

  5. Hudson CN. Acquired fistulae between the intestine and the vagina. Ann R Coll Surg Engl 1970;46:20–40.

    PubMed  Google Scholar 

  6. de Dombal FT, Watts JM, Watkinson G, Goligher JC. Incidence and management of anorectal abcess, fistula, and fissure, in patients with ulcerative colitis. Dis Colon Rectum 1966;9:201–6.

    PubMed  Google Scholar 

  7. Jackman RJ. Management of anorectal complications of chronic ulcerative colitis. Arch Intern Med 1954;94:420–4.

    Google Scholar 

  8. Edwards FC, Truelove SC. The course and prognosis of ulcerative colitis: Part III. Complications. Gut 1964;5:1–22.

    Google Scholar 

  9. Bodzin JH, Kestenberg W, Kaufmann R, Dean K. Mucosal proctectomy and ileoanal pull-through technique and functional results in 23 consecutive patients. Am Surg 1987;53:363–7.

    PubMed  Google Scholar 

  10. Harms BA, Hamilton JW, Starling JR. Management of chronic ulcerative colitis and rectovaginal fistula by simultaneous ileal pouch construction and fistula closure: report of a case. Dis Colon Rectum 1987;30:611–4.

    PubMed  Google Scholar 

  11. Edwards FC, Truelove SC. [The course and prognosis of ulcerative colitis]: Part II. Long-term prognosis. Gut 1963;4:309–15.

    Google Scholar 

  12. Stern HS, Dreznik Z. Rectovaginal fistula. Adv Surg 1987;21:245–62.

    Google Scholar 

  13. Rothenberger DA, Goldberg SM. The management of rectovaginal fistulae. Surg Clin North Am 1983;63:61–79.

    PubMed  Google Scholar 

  14. Goligher J. Surgery of the anus, rectum and colon. 5th ed. London: Baillière Tindall, 1984.

    Google Scholar 

  15. Heyen F, Winslet MC, Andrews H, Alexander-Williams J, Keighley MR. Vaginal fistulas in Crohn's disease. Dis Colon Rectum 1989;32:379–83.

    PubMed  Google Scholar 

  16. Tuxen PA, Castro AF. Rectovaginal fistula in Crohn's disease. Dis Colon Rectum 1979;22:58–62.

    PubMed  Google Scholar 

  17. Radcliffe AG, Ritchie JK, Hawley PR, Lennard-Jones JE, Northover JMA. Anovaginal and rectovaginal fistulas in Crohn's disease. Dis Colon Rectum 1988;31:94–9.

    PubMed  Google Scholar 

  18. Fazio VW, Church JM. Complications and function of the continent ileostomy at the Cleveland Clinic. World J Surg 1988;12:148–54.

    Article  PubMed  Google Scholar 

  19. Pemberton JH, Kelly KA, Beart RW Jr, Dozois RR, Wolff BG, Ilstrup DM. Ileal pouch-anal anastomosis for chronic ulcerative colitis: long-term results. Ann Surg 1987;206:504–13.

    PubMed  Google Scholar 

  20. Greenwald JC, Hoexter B. Repair of rectovaginal fistulas. Surg Gynecol Obstet 1978;146:443–5.

    PubMed  Google Scholar 

  21. Rothenberger DA, Christenson CE, Balcos EG,et al. Endorectal advancement flap for treatment of simple rectovaginal fistula. Dis Colon Rectum 1982;25:297–300.

    PubMed  Google Scholar 

  22. Jones IT, Fazio VW, Jagelman DG. The use of transanal rectal advancement flaps in the management of fistulas involving the anorectum. Dis Colon Rectum 1987;30:919–23.

    PubMed  Google Scholar 

  23. Wexner SD, Rothenberger DA, Jensen L,et al. Ileal pouch vaginal fistulas: incidence, etiology, and management. Dis Colon Rectum 1989;32:460–5.

    PubMed  Google Scholar 

  24. Jalan KN, Smith AN, Ruckley CV, Falconer CWA, Small WP, Prescott RJ. Perineal wound healing in ulcerative colitis. Br J Surg 1969;56:749–53.

    PubMed  Google Scholar 

  25. Lindquist K, Nilsell K, Liljeqvist L. Cuff abscesses and ileoanal anastomotic separations in pelvic pouch surgery: an analysis of possible etiologic factors. Dis Colon Rectum 1987;30:355–9.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Kaiser Permanente Medical Center, Oakland, California

    Eric J. Froines M.D.

  2. Department of Surgery, Kaiser Permanente Medical Center, 1425 South Main Street, 94596, Walnut Creek, California

    Donald L. Palmer M.D.

Authors
  1. Eric J. Froines M.D.
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  2. Donald L. Palmer M.D.
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Froines, E.J., Palmer, D.L. Surgical therapy for rectovaginal fistulas in ulcerative colitis. Dis Colon Rectum 34, 925–930 (1991). https://doi.org/10.1007/BF02049710

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  • DOI: https://doi.org/10.1007/BF02049710

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