Gracilis muscle transposition for fistulas between the rectum and urethra or vagina.

نویسندگان

  • Osnat Zmora
  • Hagit Tulchinsky
  • Eyal Gur
  • Gideon Goldman
  • Joseph M Klausner
  • Micha Rabau
چکیده

PURPOSE This study was designed to assess the efficacy of gracilis muscle transposition in repairing rectovaginal and rectourethral fistulas. METHODS Data were retrieved from a retrospective chart review of patients who underwent gracilis muscle transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. RESULTS Six females and three males, aged 30 to 64 years, underwent gracilis muscle transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1-66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. CONCLUSIONS Gracilis muscle transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Recto-vaginal/urethral fistula: repair with gracilis muscle transposition.

UNLABELLED This study was designed to assess the efficacy of gracilis muscle transposition in repairing recto-vaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. RESULTS Six females and four males underwent gracilis muscle transposition from 1999 to 2006. Gracilis ...

متن کامل

[Transposition of gracilis muscle for treatment of recurrent anal and rectovaginal fistula].

BACKGROUND Rectovaginal fistula is defined as a result of an abnormal connection between the rectum and vagina. It is often a result of inflammatory bowel disease, iatrogenic illness, malignancy or trauma. Rectovaginal fistula treatment is dependent on the classification of the fistula (simple or complex). There are few reports on transposition of gracilis muscle as a feasible option for treatm...

متن کامل

Muscle Interposition in Patients with Fistulas Between the Rectum and Urethra or Vagina

To the Editor—We have read with great interest the article by Zmora et al. concerning gracilis muscle interposition for surgical repair of a rectovaginal or rectourethral fistula. In the past, several techniques have been described for the treatment of these fistulas, often with rather disappointing results. It has been suggested that interposition of healthy, well-vascularized tissue may be th...

متن کامل

Recto-Neovaginal Fistula Following Vaginoplasty for Vaginal Agenesis: Our Experience and Management Guidelines

Recto-neovaginal fistula is an abnormal communication formed between the rectum and newly formed vagina, following vaginoplasty for vaginal agenesis. It results in soiling of neovagina by fecal matter and inflicts great deal of physical, social and psychological handicap on the sufferer and is one of the most dehumanizing conditions that affect women. The aim of this study was to review our exp...

متن کامل

Gracilis muscle interposition with primary rectal without urethral repair for moderate sized rectourethral fistula caused by brachytherapy for prostate cancer: a case report

INTRODUCTION There is a 0.16% chance of a rectourethral fistula after prostate brachytherapy monotherapy using Palladium-103 or Iodine-125 implants. We present an unusual case report of a rectourethral fistula following brachyradiotherapy monotherapy for prostate adenocarcinoma. It was also associated with unusual management of the fistula. CASE PRESENTATION A 58-year-old Caucasian man underw...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Diseases of the colon and rectum

دوره 49 9  شماره 

صفحات  -

تاریخ انتشار 2006