Rectovaginal fistulas have a multitude of causes and it is well known that obstetric and gynecological problems form a large part of these causes such as our case.
PRESENTATION OF CASE
We present a 45-year-old female that presented with complaints of stool per vagina and was found to have a rectal vaginal fistula near the vaginal cuff from her previous uncomplicated vaginal hysterectomy. The patient was originally scheduled for a complex open abdominal surgery based on examination but underwent a sigmoidoscopy with vaginal examination and identified a small opening with minimal inflammation. The patient was treated with Bioglue® and had complete resolution of the fistula at follow-up.
DISCUSSION
There are numerous cases presented in the literature on the use of bioglue for anal fistulas and rectovaginal fistulas with multiple cases of success. However, in looking at the literature failure appears to be due to ongoing inflammation from the previous disease process.
CONCLUSION
Although the use of Bioglue® may not be suitable for all patients with rectovaginal fistulas, it offers yet another treatment modality for select patients.