Graciloplasty for rectourethral, rectovaginal and rectovesical fistulas: technique overview, pitfalls and complications

Ruiz, Dan; Bashankaev, Badma; Speranza, Jenny R.; Wexner, Steven D.; Rabau, Micha

doi:10.1007/s10151-008-0433-7

Cited by 28 publications

(14 citation statements)

References 13 publications

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“…Wexner et al [21,22] in 2008 used the technique of graciloplasty in performing RVFs for a group of 15 patients. This method led to a success rate of 75% (range, 60-100%), determined by negative prognostic factors such as inflammatory bowel disease and radiation.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive treatment of rectovaginal fistula

D’Ambrosio¹,

Paganini²,

Guerrieri

et al. 2011

Surg Endosc

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Section: Discussionmentioning

confidence: 99%

Minimally invasive treatment of rectovaginal fistula

D’Ambrosio¹,

Paganini²,

Guerrieri

et al. 2011

Surg Endosc

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“…These different techniques involve proper and correct positioning of the patient, excision of the fistulous tract, tension-free approximation of the surgical edges, and, in some cases, separation of the urethral/rectal suture lines by interposition of pedicle flap (Gracilis muscle flap, Dartos pedicle flap, rectal advancement flap) in order to guarantee an effective urinary and fecal diversion [6].…”

Section: Discussionmentioning

confidence: 99%

Transanal endoscopic microsurgery-assisted rectal advancement flap is a viable option for iatrogenic rectourethral fistula repair: a case report

2011

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Rectourethral fistula (RUF) is a relatively rare complication of radical prostatectomy, but is extremely difficult to treat. Multiple surgical approaches have been described for definitive treatment, but to date none of them have been determined to be the gold standard, either due to a high recurrence rate of the condition or due to the morbidity associated with the procedure. In this case report, we describe a successful repair of iatrogenic RUF through a multidisciplinary approach consisting of cystoscopy, urethral stent placement, colonoscopy, and TEM-assisted rectal advancement flap.

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“…In 2008, Wexner et al (25,26) used the graciloplasty technique for RVF repair in a group of 15 patients. This method led to a 75% success rate (range, 60-100%), determined by negative prognostic factors such as inflammatory bowel disease and radiation.…”

Section: Discussionmentioning

confidence: 99%

Transanal endoscopic microsurgical treatment of rectovaginal fistula: an original technique

D’Ambrosio¹

2014

PER

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SummaryBackground: rectovaginal fistulas (RVFs) are a rare surgical condition. Their treatment is extremely difficult, and no standard surgical technique is accepted worldwide. This report describes a new approach using transanal endoscopic microsurgery (TEM) to treat RVFs. Materials and Methods: a retrospective review of 13 patients who underwent repair of rectovaginal fistula using TEM between 2001 and 2008 was undertaken. The surgical technique is widely described, and the advantages of the endorectal approach are well-known. Results: the median follow-up period was 25 months, and the median age of the patients was 44 years old (range, 25-70 years old). The mean operative time was 130 min (range, 90-150 min), and the hospital stay was 5 days (range, 3-8 days). One patient experienced recurrence. This patient underwent reoperation with TEM and experienced re-recurrence. Two patients had minor complications (hematoma of the septum and abscess of the septum), which were treated with medical therapy. For two patients, a moderate sphincter hypotonia was recorded.Discussion: a new technique for treating RVFs using TEM is presented. The authors strongly recommend this approach that avoids any incision of the perineal area, which is very painful and can damage sphincter functions.

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Graciloplasty for rectourethral, rectovaginal and rectovesical fistulas: technique overview, pitfalls and complications

Abstract: This technical note describes the surgical technique of graciloplasty as an option for the treatment of rectovaginal, rectourethral and rectovesical fistulas.

Cited by 28 publications

References 13 publications

Minimally invasive treatment of rectovaginal fistula

Minimally invasive treatment of rectovaginal fistula

Transanal endoscopic microsurgery-assisted rectal advancement flap is a viable option for iatrogenic rectourethral fistula repair: a case report

Transanal endoscopic microsurgical treatment of rectovaginal fistula: an original technique

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