Abstract
Rectovaginal fistula represents a challenging and often frustrating clinical entity for patients and surgeons alike. Despite a plethora of available approaches for repair, rates of non-healing and recurrence remain high. As a result, patients often require multiple attempts at repair before a satisfactory outcome is achieved. The surgical literature is replete with observational studies consisting of single-institution case series; however, there is a lack of level 1 evidence to support definitive recommendations. In this chapter, we summarize the available literature regarding procedures used to treat recurrent rectovaginal fistulas, then, supplement this with recommendations and observations from clinical practice. Specifically, we focused on endorectal/mucosal advancement flaps, tissue transposition techniques, and biologic mesh repair.
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Lawson, E.H., Roberts, P.L. (2017). Benign Anal Disease: Management of the Recurrent Anovaginal/Rectovaginal Fistula. In: Hyman, N., Umanskiy, K. (eds) Difficult Decisions in Colorectal Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-40223-9_33
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