Definitive repair of anovaginal fistula in Crohn's disease

Abstract

Anovaginal fistula may be a very distressing complication of Crohn's disease. We review the definitive repair of such fistulas in ten patients. The objectives were to cure the fistula, maintain continence and avoid proctectomy. The fistula was low trans-sphincteric in five patients, high trans-sphincteric in three and suprasphincteric in two. Loop ileostomies were formed in nine patients. Overall, after 14 repair procedures 8/10 fistulas are healed. Seven remain healed at a mean of 38 months (range 10-66 months) after ileostomy closure (six) or repair without ileostomy (one). All of the patients are continent. Definitive repair is effective and worthwhile in selected patients with Crohn's anovaginal fistula.