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Pediatric Surgery International
Published in: Pediatric Surgery International 6/2014

01-06-2014 | Original Article

Rectovestibular fistula with vaginal atresia: our experience and a proposed course of management

Authors: Sundeep Kisku, Ravi Kishore Barla, Sudipta Sen, Sampath Karl, John Mathai, Lilly Varghese

Published in: Pediatric Surgery International | Issue 6/2014

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Abstract

Background

Rectovestibular fistula with coexisting vaginal atresia poses a surgical dilemma with regard to the timing and type of reconstruction. We present our experience and suggest an appropriate course of management.

Methods

Seven patients with rectovestibular fistula and coexisting vestibular atresia were operated in our hospital during January 2004 through December 2013. The details of their bowel, menstrual and sexual functions were recorded.

Results

Five of the seven patients who underwent anoplasty in childhood presented to us in their teens with primary amenorrhea and cyclical abdominal pain. All five had sigmoid colon neovaginoplasty. Four of these had the uterus or its remnants anastomosed to the neovagina. All four have regular menstrual cycles. One patient is sexually active and has satisfactory sexual function. The bowel function in all the five patients is good. The remaining two patients presented in their infancy and had the anorectovestibular fistula left as the neovagina. The recto-sigmoid was pulled down to form the neoanus. Both these patients have bowel incontinence.

Conclusion

We recommend the rectovestibular fistula be used as the neoanus and not as the neovagina. Delayed bowel vaginal replacement has excellent results and allows for optimal assessment of functioning uterine body or remnants.
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Metadata
Title
Rectovestibular fistula with vaginal atresia: our experience and a proposed course of management
Authors
Sundeep Kisku
Ravi Kishore Barla
Sudipta Sen
Sampath Karl
John Mathai
Lilly Varghese
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 6/2014
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-014-3517-7

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