Pattern of non-obstetric infectious recto-vaginal fistula: a case series and literature review in Cameroon, Central Africa

Tebeu, Pierre Marie; Ekono, Roger Guy Michel; Fouogue, Jovanny Tsuala; Halle, Gregory Ekane; Fokom, Joel Domgue; Rochat, Charles-Henry

doi:10.18203/2320-1770.ijrcog20162101

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…The defect is often large with fibrosis, fixation of tissues, and associated poor vascularity (15). Closure of the defects by the usual techniques carries a high failure rate (16). A diverting colostomy may often be the only possible treatment for palliation of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Clinical spectrum, management, and outcome of rectovaginal fistulae

Sibiya¹,

Ramphal²,

Madiba³

et al. 2022

Ann Afr Surg.

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

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Section: Discussionmentioning

confidence: 99%

Clinical spectrum, management, and outcome of rectovaginal fistulae

Sibiya¹,

Ramphal²,

Madiba³

et al. 2022

Ann Afr Surg.

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“…Primary infection and malignancy have also been cited as rare causes of RVF. 7 8 Etiologies such as inflammatory bowel disease (IBD) and radiation therapy are common in Western countries, but their prevalence is not well known in LMICs where the diagnosis of IBD is uncommon and access to radiation therapy rare.…”

Section: Prevalence and Etiologymentioning

confidence: 99%

Rectovaginal Fistula Management in Low-Resource Settings

Lussiez

Nardos

Lowry

2022

Clin Colon Rectal Surg

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Rectovaginal fistula (RVF) is an abnormal connection between the rectum and vagina that affects women globally. In low- and middle-income countries (LMIC), RVF is most commonly due to obstetric complications such as prolonged labor or perineal tears, female genital mutilation and trauma such as sexual violence or iatrogenic surgical injuries. Women affected by this condition suffer from debilitating physical symptoms, social isolation, economic disempowerment, psychological trauma, low self-esteem, and loss of role fulfillment. Lack of accessible, high-quality, and effective healthcare is a major barrier to timely and safe obstetric care and to care for subsequent complications such as RVF. Additionally, social, cultural, financial, and systemic barriers put women at risk of acquiring fistula and contribute to delays in seeking and receiving care. Literature evaluating RVF repair in those able to access care offers limited information about management and outcomes. It is difficult to ascertain which surgical techniques are used. To reduce the burden of this often-preventable disease, appropriate investment in healthcare infrastructure to strengthen maternal care in LMICs is paramount. Furthermore, more standardized reporting of severity and treatment approach along with outcome data are critical to improving the quality of care for patients impacted by RVF.

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Pattern of non-obstetric infectious recto-vaginal fistula: a case series and literature review in Cameroon, Central Africa

Cited by 2 publications

References 9 publications

Clinical spectrum, management, and outcome of rectovaginal fistulae

Clinical spectrum, management, and outcome of rectovaginal fistulae

Rectovaginal Fistula Management in Low-Resource Settings

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