Clinical Spectrum, Management, and Outcome of Rectovaginal Fistulae
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 between 2006 and 2018 and analysis included demographics, aetiol...
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| Format: | Article |
| Language: | English |
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Surgical Society of Kenya
2022-10-01
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| Series: | The Annals of African Surgery |
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| Online Access: | https://www.annalsofafricansurgery.com/rectovaginal-fistulae |
| _version_ | 1828385353085485056 |
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| author | Silindokuhle Revivial Sibiya Surandhra Ramphal Thandinkosi Madiba Frank Anderson |
| author_facet | Silindokuhle Revivial Sibiya Surandhra Ramphal Thandinkosi Madiba Frank Anderson |
| author_sort | Silindokuhle Revivial Sibiya |
| collection | DOAJ |
| description | 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 between 2006 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. |
| first_indexed | 2024-12-10T05:19:06Z |
| format | Article |
| id | doaj.art-f9fffa2036af46459ae42950ef496001 |
| institution | Directory Open Access Journal |
| issn | 1999-9674 2523-0816 |
| language | English |
| last_indexed | 2024-12-10T05:19:06Z |
| publishDate | 2022-10-01 |
| publisher | Surgical Society of Kenya |
| record_format | Article |
| series | The Annals of African Surgery |
| spelling | doaj.art-f9fffa2036af46459ae42950ef4960012022-12-22T02:00:52ZengSurgical Society of KenyaThe Annals of African Surgery1999-96742523-08162022-10-01194200206http://dx.doi.org/10.4314/aas.v19i4.7Clinical Spectrum, Management, and Outcome of Rectovaginal FistulaeSilindokuhle Revivial Sibiya0https://orcid.org/0000-0002-9768-7202Surandhra Ramphal1https://orcid.org/0000-0002-4128-0112Thandinkosi Madiba2https://orcid.org/0000-0002-0155-9143Frank Anderson3https://orcid.org/0000-0002-9055-8037University of KwaZulu-Natal, Durban, South AfricaUniversity of KwaZulu-Natal, Durban, South AfricaUniversity of KwaZulu-Natal, Durban, South AfricaUniversity of KwaZulu-Natal, Durban, South AfricaBackground: 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 between 2006 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.https://www.annalsofafricansurgery.com/rectovaginal-fistulaerectovaginal fistulafistula repairfistula management |
| spellingShingle | Silindokuhle Revivial Sibiya Surandhra Ramphal Thandinkosi Madiba Frank Anderson Clinical Spectrum, Management, and Outcome of Rectovaginal Fistulae The Annals of African Surgery rectovaginal fistula fistula repair fistula management |
| title | Clinical Spectrum, Management, and Outcome of Rectovaginal Fistulae |
| title_full | Clinical Spectrum, Management, and Outcome of Rectovaginal Fistulae |
| title_fullStr | Clinical Spectrum, Management, and Outcome of Rectovaginal Fistulae |
| title_full_unstemmed | Clinical Spectrum, Management, and Outcome of Rectovaginal Fistulae |
| title_short | Clinical Spectrum, Management, and Outcome of Rectovaginal Fistulae |
| title_sort | clinical spectrum management and outcome of rectovaginal fistulae |
| topic | rectovaginal fistula fistula repair fistula management |
| url | https://www.annalsofafricansurgery.com/rectovaginal-fistulae |
| work_keys_str_mv | AT silindokuhlerevivialsibiya clinicalspectrummanagementandoutcomeofrectovaginalfistulae AT surandhraramphal clinicalspectrummanagementandoutcomeofrectovaginalfistulae AT thandinkosimadiba clinicalspectrummanagementandoutcomeofrectovaginalfistulae AT frankanderson clinicalspectrummanagementandoutcomeofrectovaginalfistulae |