Operative results, sexual function and quality of life after gracilis muscle transposition in complex rectovaginal fistulas

Aim Successful treatment of complex rectovaginal fistulas (RVFs) continues to be a surgical challenge. Interposition of well‐perfused tissue, such as gracilis muscle, is one treatment option. The aim of this study was to investigate the operative results, sexual function and quality of life after gr...

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Bibliographic Details
Published in:Colorectal disease 2019-12, Vol.21 (12), p.1429-1437
Main Authors: Kersting, S., Athanasiadis, C.‐J., Jung, K.‐P., Berg, E.
Format: Article
Language:English
Subjects:
Complications
Fistula
functional outcome
Gracilis muscle transposition
Muscles
Patient satisfaction
Patients
Quality of life
rectovaginal fistula
Transposition
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Summary:Aim Successful treatment of complex rectovaginal fistulas (RVFs) continues to be a surgical challenge. Interposition of well‐perfused tissue, such as gracilis muscle, is one treatment option. The aim of this study was to investigate the operative results, sexual function and quality of life after gracilis muscle transposition (GMT) in the authors’ own group of patients. Method The study included 19 women with RVF (mean age 48 years). The postoperative outcome was evaluated by a questionnaire and clinical examination. Results The postoperative follow‐up period was 7 months to 3.5 years (mean 23 months). GMT led to primary healing of RVF in 10 (53%) patients. Recurrences were observed in nine (47%) patients with RVF, in four (44%) of whom healing was achieved as a result of further interventions. Following GMT, two complications (abscess formation) requiring revision occurred. Although 42% of the patients reported certain limitations following muscle removal, GMT is a procedure that has a positive influence on the healing rate (74%), quality of life, continence and patient satisfaction. Conclusion GMT is a procedure that allows healing in the majority of patients with RVFs, and it should be considered especially in patients with recurrent fistulas, in whom a correlation between decreasing healing rates and the number of previous operations has been demonstrated.
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.14741