The surgical management of H-type rectovestibular fistula: a case report and brief review of the literature

Kelleher, Deirdre C.; Henderson, Peter W.; Coran, Arnold G.; Spigland, Nitsana

doi:10.1007/s00383-012-3064-z

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…Thus far no exact incidence of this condition has been reported, but generally it is more common in Asian countries than in western countries [1][2][3]. Most investigators agree that the operative procedure is best accomplished through an anterior perineal or transanal approach [3,4] despite the etiological controversy on whether it is a congenital or acquired fistula. This condition does not interfere with development and growth, and daily life inconvenience is also rare.…”

Section: Discussionmentioning

confidence: 98%

Anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children

Wang¹,

Chen²,

Zhang³

et al. 2015

Journal of Pediatric Surgery

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The purpose of this study was to review a 7-year operative experience of anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children. From January 2007 to December 2013, 105 female children with H-type rectovestibular fistula and a normal anus underwent anterior perineal fistulectomy in the Department of General Surgery, Beijing Children's Hospital, Capital Medical University. Clinical data were retrospectively analyzed. Patients' age ranged from 6 months to 13 years 10 months, with an average age 5 years 2 months. The clinical feature of this disease was a definite history of vestibular infection at about 30 days after birth and leakage of gas or loose stool through vestibular fistular orifice after the infection was controlled. All patients had a normal anus. Follow-up through telephone or outpatient visits from 6 months to 7 years (median, 5.2 years), showed that all the patients were continent and had regular bowel movements. Among the 105 patients, 97 (92.4%) gained primary healing with a satisfactory appearance; 8 (7.6%) patients relapsed, among which 5 healed after hip bathing treatment within 3 weeks, 2 required another anterior perineal fistulectomy 7 months later and were cured, and the last one had another anterior perineal fistulectomy 1 year 10 months later but relapsed again, which healed after hip bathing treatment within 3weeks after the second surgery. Anterior perineal fistulectomy is a simple, safe and reliable surgical method to treat H-type rectovestibular fistula with a normal anus.

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Section: Discussionmentioning

confidence: 98%

Anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children

Wang¹,

Chen²,

Zhang³

et al. 2015

Journal of Pediatric Surgery

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“…H-type rectourethral fistula with anal stenosis is a rare variant of ARMs [4]. The incidence of this anomaly is higher in Asian than that in western countries with a female predominance [3][4][5]8]. DeVries and Friedland first described this anomaly in 1974 [11].…”

Section: Discussionmentioning

confidence: 99%

“…In females, the passage of stool out of the vagina is the usual presenting feature. The diagnosis can be confirmed by contrast study (VCUG and barium enema), MRI, and endoscopy, revealing the fistulous connection between the rectum and urethra [5,7]. However, these cases are usually diagnosed late (as in H-type tracheoesophageal fistula) because of the lack of external findings [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…The H-type rectourethral fistula is a rare variant of anorectal malformation that occurs in male patients, and it is usually associated with delayed diagnosis due to the presence of a normal anus [4]. This deformity is more commonly reported in female patients and is usually an acquired problem secondary to inflammatory events affecting the genitourinary system [4][5][6]. The diagnosis of this anomaly is confirmed by contrast study (barium enema and voiding cystourethrography), MRI, and endoscopy, revealing the fistulous connection between the rectum and urethra [5,7].…”

Section: Introductionmentioning

confidence: 99%

“…This deformity is more commonly reported in female patients and is usually an acquired problem secondary to inflammatory events affecting the genitourinary system [4][5][6]. The diagnosis of this anomaly is confirmed by contrast study (barium enema and voiding cystourethrography), MRI, and endoscopy, revealing the fistulous connection between the rectum and urethra [5,7]. Many surgical procedures can be used to correct this anomaly, including limited posterior sagittal anorectoplasty (PSARP), anterior rectal wall pullthrough, and endorectal pull-through operations [4,8].…”

Section: Introductionmentioning

confidence: 99%

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H-type Rectourethral Fistula with Anal Stenosis in a Male Patient: A Case Report with Literature Review

Edan¹

2022

Integi J Med Sci

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Background: H-type rectourethral fistula is a rare variant of anorectal malformation that affects male neonates. It is usually associated with anal stenosis but with a normal anal position and shape, so it is difficult to be diagnosed early after birth. We present this case to evaluate the functional outcome of this rare anomaly in a male patient and compare it with other reported cases with different ages at diagnosis. Case Presentation: A nine-month-old infant presented with recurrent attacks of urinary tract infection and failure to thrive. After proper evaluation, the diagnosis of an H-type rectourethral fistula with anal stenosis was confirmed, and a diverting double-barreled colostomy was performed as an initial procedure. Posterior sagittal anorectoplasty with ligation and division of fistula was successfully done, followed by colostomy closure. Now the patient is five years old and is continent for urine and stool. Conclusions: The diagnosis of H-type rectourethral fistula with anal stenosis is challenging to physicians, and a high index of suspicion is required to reach the diagnosis as the anal opening had a normal shape and location. If this condition is diagnosed and treated early, these patients will have an excellent functional prognosis, as the muscle complex and anal sphincter are well developed.

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Miscellaneous Conditions

Peña¹,

Bischoff²

2015

Surgical Treatment of Colorectal Problems in Children

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The surgical management of H-type rectovestibular fistula: a case report and brief review of the literature

Cited by 12 publications

References 11 publications

Anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children

Anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children

H-type Rectourethral Fistula with Anal Stenosis in a Male Patient: A Case Report with Literature Review

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