Journal of the Anus, Rectum and Colon
Online ISSN : 2432-3853
CASE REPORT
Successful repair of a rectovaginal fistula caused by a tension-free vaginal mesh (TVM): a case report
Yoshikazu KoideKotaro MaedaTsunekazu HanaiKoji MasumoriHiroshi MatuokaHidetoshi KatsunoTomoyoshi EndoMiho ShiotaMasahiro MizunoYeong Cheol Cheong
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2018 Volume 2 Issue 2 Pages 66-69

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Abstract

Rectovaginal fistula caused by a tension-free vaginal mesh (TVM) is a rare condition. Moreover, a rectovaginal fistula is a challenging issue to address for surgeons regardless of causes. Due to a low rate of occurrence, treatment modality for a rectovaginal fistula caused by a TVM has previously received little attention. A successful surgery using several key techniques to address a rectovaginal fistula caused by a TVM is herein reported. A 78-year-old woman who underwent a TVM for a rectocele three months ago was referred to our hospital with a two-month history of anal bleeding. Mesh protruding into both the vagina and the rectum was confirmed. The patient was operated on under diagnosis of a rectovaginal fistula caused by TVM. TVM was removed by transvaginal dissection of the rectovaginal septum with division of both anterior and posterior arms of the TVM. Layer-to-layer sutures of rectal and vaginal walls were crossly performed with a drain placed in the rectovaginal septum after saline irrigation followed by a covering sigmoid colostomy. The wound healed without infection after surgery, and a water-soluble contrast enema demonstrated the healing of the rectovaginal fistula two months after surgery. No recurrent fistula was confirmed 15 months after stoma closure.

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© 2018 The Japan Society of Coloproctology
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