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Open Access 25-04-2022 | Dyspareunia | main topic

Surgical treatment of deep-lying ano-/rectovaginal fistulas using a de-epithelialized “Singapore flap” (pudendal thigh flap)

Authors: Siegfried Sauseng, MD MBA FEBS, Josip Kresic, Marcel Mayerhofer, Marilia Aislynn Ribeiro Skreinig, Lars-Peter Kamolz, Stephan Spendel, Michael Schintler, Arvin Imamovic, Johann Pfeifer

Published in: European Surgery | Issue 3/2022

Summary

Background

Rectovaginal fistulas represent 5% of all anorectal fistulas. For affected women, this pathology is associated with a reduction in quality of life (QoL) and self-esteem. Most commonly used methods of surgical closure have high recurrence rates or permanent perineal complaints, which in turn lead to negative effects on QoL and self-esteem. A fistula closure, using the “de-epithelialized Singapore flap” (SF), can be a good alternative therapy strategy.

Method

Our retrospective case series processes the long-term results of seven patients who were operated on for ano-/rectovaginal fistula using the SF. All patients underwent surgery at the University Hospital Graz, between May 2012 and July 2015. The data of the surgical follow-up examinations were collected and an additional telephone survey was carried out. The procedure is presented based on a structured description. All procedures were performed jointly by the Department of General Surgery and the Department of Plastic Surgery.

Results

The average age of the seven patients was 46.14 years (23–72 a). Five patients had a total of 12 previous operations with frustrating results. Of the seven patients treated, six had a permanent fistula closure (85.7%). The results of the telephone survey (n = 6) showed a high level of patient satisfaction (100%), and an improvement in QoL (83.3%), through our surgical method. In our cohort, neither urinary nor fecal incontinence occurred.

Conclusion

The treatment of an ano-/rectovaginal fistula using the “de-epithelialized pudendal thigh flap” (Singapore flap) is a promising treatment alternative. In particular, patients who have had previous proctological interventions show a benefit from this procedure.

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Title: Surgical treatment of deep-lying ano-/rectovaginal fistulas using a de-epithelialized “Singapore flap” (pudendal thigh flap)
Authors: Siegfried Sauseng, MD MBA FEBS
Josip Kresic
Marcel Mayerhofer
Marilia Aislynn Ribeiro Skreinig
Lars-Peter Kamolz
Stephan Spendel
Michael Schintler
Arvin Imamovic
Johann Pfeifer
Publication date: 25-04-2022
Publisher: Springer Vienna
Keyword: Dyspareunia
Published in: European Surgery / Issue 3/2022
Print ISSN: 1682-8631
Electronic ISSN: 1682-4016
DOI: https://doi.org/10.1007/s10353-022-00759-7

At a glance: The STEP trials

Springer Medicine

Surgical treatment of deep-lying ano-/rectovaginal fistulas using a de-epithelialized “Singapore flap” (pudendal thigh flap)

Summary

Background

Method

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Summary

Background

Method

Results

Conclusion

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