Gynecologic and urologic fistulas High rectovaginal fistulas Complications of pelvic surgery can include high rectovaginal fistulas. The erroneous placement of the surgical stapler into the vagina or the inadvertent trapping of a fold of vaginal wall between the two ends of the end to end stapling device can result in such a fistula. Post-operative infections can result in the formation of a delayed fistula. Examples include a patient with a vaginal cuff abscess following hysterectomy or one with a contained anastomotic leak after a low anterior resection that necessitates the abscess through a rectovaginal fistula. Surgical repair of these symptomatic fistulas is usually required.
Options vary from local closure to advancement flaps to interposition of vascularized flaps.
The close anatomical relationship of the bowel to the organs of the gynecologic and urinary systems is primarily responsible for the occurences of a disease process originating in one of these systems affecting the other. Differentiating both the organ of origin of the disease process as well as the benign versus malignant nature of the disease allows for careful and accurate patient management. Internal fistulas in diverticular disease. Accuracy of computerized tomography in the diagnosis of colovesical fistula secondary to diverticular disease. Indications and strategies for the surgery of Crohn's disease.