Experiences of Rectovaginal Fistula in Anorectal Malformation
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In brief
In brief
Retrospective study of 7 rectovaginal fistula cases among 460 anorectal malformation patients shows RVF represents 3.4% of female ARMs. Most patients achieved voluntary bowel movements by age 5-10, though soiling and constipation remained common, emphasizing need for long-term bowel management counseling.
Written by the GCMD Library team from the article.
Background
Rectovaginal fistulas (RVFs) are very rare malformations in females with anorectal malformations (ARMs). Here, we share the clinical features of RVF and report the long-term outcomes.
Methods
RVF patients were classified using a retrospective analysis of ARM patients who underwent operations at Seoul National University Hospital between January 1999 and May 2017. The Krickenbeck continence scoring system was used to evaluate bowel function 5 and 10 years after surgery.
Results
Of the total 460 ARM patients, 203 were female, 7 of whom were diagnosed with RVF. The median age and weight at the time of anorectoplasty were 292 days (range, 140–617) and 8.2 kg (range, 5.5–12), respectively. Six patients had associated anomalies and three patients underwent redo-anorectoplasty. Voluntary bowel movements were observed in 6 out of 7 patients at 5 and 10 years of age. Soiling was observed in all patients at the age of five years and in 6 out of 7 patients at the age of ten years. Constipation was observed in 6 out of 7 patients at both five and ten years of age.
Conclusions
An RVF is a very rare malformation, accounting for 1.5% of total ARMs and 3.4% of ARMs in females. Long-term counseling, education, and guidance are needed for effective management of patients' bowel movements.
Type of study
Prognosis study
Level of evidence
Level IV