Interposition of vital bulbocavernosus graft in the treatment of both simple and recurrent rectovaginal fistulas

Abstract

Objective: The objective of the study is to assess the efficacy of vital bulbocavernosus graft transposition in the treatment of rectovaginal fistula.

Materials and methods: From March 2003 to October 2007, nine consecutive patients diagnosed with rectovaginal fistula were refereed to our institute. All patients were treated using an interposing vital bulbocavernosus graft between rectum and vagina.

Results: Median patient age was 33 years (range, 19-61) and seven of the nine patients had undergone between one and six fistula repair sessions prior to this grafting procedure. The etiology included congenital in three, surgery injury in four, obstetric in one, and radiation in one. No wound infections or abscesses occurred postoperatively, and the in-hospital mortality rate was zero. No recurrence was reported during the follow-up period and all patients had normal fecal continence. Only one patient had mild dyspareunia and no further surgical treatment needed.

Conclusion: Both simple and complex rectovaginal fistula can be reliably repaired using a bulbocavernosus graft.