2021 Volume 57 Issue 4 Pages 759-764
Surgery for rectovestibular fistula with a normal anus is problematic because of the high incidence of recurrence. We performed perineal body repair for rectovestibular fistula in three children. During the surgery, a transverse incision was made in the perineal skin at the lithotomy position, and the perineum was dissected deeply to reach the perineal body, and a fistula was removed. The external extension of the perineal body, a connective tissue mass extending laterally from the perineal body to the left and right sides, was identified; this was tractioned bilaterally to the median and then closed by suture in layers from the depths to reshape the perineal body. Two of the three patients had a history of labial swelling at one month of age, and fistulas were found in the vestibular region. One patient became aware of vaginal gas at around 10 years of age, and at 12 years of age, stool began to leak from the vagina, and an intraoperative fistula running from the left side of the vestibule to the rectum on the oral side of the dentate line was observed. All patients had a good postoperative course without recurrence, infection or defecation problems. This technique can be used in patients with fistulas that do not have a clear site or after a recurrence.
