Lesions may originate as Allen-Masters peritoneal defects, developing into deeply infiltrative rectovaginal
De este modo, suele afectar el compartimiento anterior (infiltracion de ligamentos redondos y de la pared vesical) (Crispi et al., 2012); la pared lateral de la pelvis (infiltracion de ureteres, plexos nerviosos hipogastricos, etc.) (Chapron et al., 2010; Ceccaroni et al., 2011; Munoz et al., 2012); el compartimiento posterior (compromiso de parametrios, ligamentos uterosacros, vagina, el tabique rectovaginal
y el recto) (Chopin et al., 2005; Dadhwal et al., 2012; Milone et al., 2015); y otro organos como intestino delgado, sigmoides, ciego y apendice cecal (Fernandez-Rey et al., 2009; Villarreal-Peral et al., 2011).
During LVMR, the rectum is mobilized ventrally and the rectovaginal
septum is dissected to the lowest part of the pelvic floor.
examination also suggested fullness in the rectouterine pouch.
Accompanying presence of air both in fistulous tract and in the rectovaginal
septum is an important diagnostic clue for accurate diagnosis (15).
When the pouch of Douglas (rectovaginal
space) is obliterated by a tumor, severe adhesions or endometriosis, the surgeon should primarily open the retroperitoneal space, find the ureter, and after ureterolysis the pararectal space should be developed to dissect the rectum from the vagina and open the rectovaginal
(10) HAM has been investigated and demonstrated significant effects on wound healing of rectovaginal
fistula, gastrointestinal tract, colon, and duodenum.
A colposcopic evaluation of the cervix and vagina accompanied with a thorough bimanual rectovaginal
examination should always be performed first.
Endometriosis commonly occurs in the peritoneum, ovaries, and rectovaginal
septum, but may also be found in other abdominal or extra-abdominal sites.
Kutna said they are going to set up a Vesicovaginal fistula/ Rectovaginal
fistula facility at Siaya county referral hospital and Bondo Sub-county hospital to reduce the rate of the disease.
* Fistulas (vesicovaginal, ureterovaginal and rectovaginal