Recto Perineal Fistula Case Study

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Recto perineal fistula: The operation to repair this defect is performed at birth in order to avoid cosmetic, psychological and potential obstetric consequences in the future. This operation is done before the baby leaves the hospital during the newborn period. The patient is placed in prone position with the pelvis elevated. Multiple 6/0 silk stitches are placed around the fistula site. The incision is about 1.5–2 cm long and divides the entire sphincter mechanism in the posterior midline. The rectum is dissected as previously described in the case of perineal fistulas in male patients. The perineal body is reconstructed and the rectum is anchored to the posterior edge of the muscle complex. An anoplasty is performed and These patients can…show more content…
If the total urogenital mobilization proves not be enough to repair the malformation, then the operation must be completed through a laparotomy. The separation of the rectum from the vagina is not difficult in very high malformations since it is similar to what is described in the separation of the rectum from the bladder neck in male patients. On the other hand, the separation of the vagina from the urinary tract in a case of a cloaca with a long common channel is a very delicate maneuver that requires expertise and finesse. Once the vagina has been completely separated, which is a maneuver that may take several hours, the surgeon then has to make important decisions considering the way to repair the vagina. The separation of the vagina from the urinary tract should be performed with the bladder open in the midline and with ureteral catheters. The ureters run through the common wall that separates the vagina from the bladder and therefore, the surgeon should be ready to deal with the fact that the ureters may be right in the plane of separation. Once the vagina has been separated, the size of the mobilized vaginas should be measured and the length needed to bring the vagina down. It

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