Clinical spectrum, management, and outcome of rectovaginal fistulae

Background: There are limited reports on rectovaginal fistulae in South Africa. Methods: This was a prospective analysis of all patients undergoing treatment for RVF at tertiary referral hospital. Data extracted from the database between2006 and 2018 included demographics, aetiology, management, outcome. The main outcome measure healing fistula. Results: Fifty were identified [Median age 36 (IQR 28-42) years]. HIV status positive (31), negative (5) unknown (14). Commonest causes obstetric (17), perineal sepsis (14) spontaneous (8) (Table 2). Median duration symptoms 34.5 months 5-72) (Diagram 1). Forty-two underwent 55 surgical procedures (including 14 redos). In 32 repair undertaken under colostomy cover 28/42 healed after initial (66.7%), final success rate (41/42) 97.6%. Two eight non-operative management (25%). Conclusion: Obstetric injury leading cause RVF. predominated. Spontaneous seen immunocompromised patients. Success 97.6% over time 3 months. Non-operative led to 25% cases.