Transvaginal repair of recurrent pouch-vaginal fistula.

Abstract

Pouch-vaginal fistula is an uncommon but unpleasant complication. The chance of successful repair with various surgical procedures is around 50% and the early promise of collagen button plugs was not followed by good long-term results. We report a series of patients who underwent transvaginal repair of pouch-vaginal fistula after failed collagen plugs accompanied by a video to show the operative technique. Patients were identified from a prospectively maintained database. Patient demographics, operation notes, complications and ultimate outcome were recorded. Eleven patients, each of whom had previously undergone an attempt to close the fistula with a collagen button plug, underwent transvaginal repair. Nine (81%) were successful at a median follow-up of 14 (6-56) months. The remaining two patients reported symptomatic improvement. Pouch-vaginal fistula can be successfully closed by the transvaginal technique after a failed button plug procedure.