doiSerbia

Recto-vaginal/urethral fistula: Repair with gracilis muscle transposition

Rabau Micha (Colorectal Unit, Division of surgery B, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel)
Zmora Osnat (Colorectal Unit, Division of surgery B, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel)
Tulchinsky Hagit (Colorectal Unit, Division of surgery B, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel)
Gur Eyal (Department of plastic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv)
Goldman Gideon (Colorectal Unit, Division of surgery B, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel)

This study was designed to assess the efficacy of gracilis muscle transposition in repairing rectovaginal 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 muscle transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.

Keywords: gracilis muscle, rectovaginal fistula, rectourethral fistula