Innovative Technique for the Closure of Rectovaginal Fistula Using Amplatzer™ Septal Occluder

Abstract

Rectovaginal fistulas (RVF) result from an abnormal epithelial connection between the vagina and the rectum, allowing the intestinal contents to pass through the vagina.1 Patients may clinically present with vaginal faeces or gas discharge in addition to inflammation in the pelvic cavity, which may lead to severe infection and poor quality of life.2 RVF is seen in women who previously received treatment for a malignant disease in the pelvic region. The malignancies in the pelvic area are often treated with radiotherapy. This treatment results in tissue damage and poor healing.3 Management of postoperative RVF is difficult and the results are often unsatisfactory. Currently there is no widely accepted and standardized treatment for RVF.3, 4 In the treatment of RVF, various surgical flaps (endorectal or vaginal), vascular tissue flaps (Martius, gracilis), grafts or biomaterials have been used.3,5,6 This case shows the first results using the Amplatzer™ Septal Occluder for the closure of rectovaginal fistula.