The Role of Graciloplasty in the Treatment of Obstetric Anal Sphincter Injury with Subsequent Fecal Incontinence and Recurrent Low Recto-Vaginal Fistula: A Case Report

<b>Background and Clinical Significance</b>: Recto-vaginal fistulae (RVF) and fecal incontinence (FI) pose significant challenges for colorectal surgeons. Various therapeutic options have been proposed for each condition over time. Despite its procedural complexity and the risk of compli...

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Main Authors: Alessandro Bergna, Jacques Megevand, Giacomo Mori, Leonardo Lenisa, Andrea Rusconi
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Reports
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Online Access:https://www.mdpi.com/2571-841X/8/1/11
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author Alessandro Bergna
Jacques Megevand
Giacomo Mori
Leonardo Lenisa
Andrea Rusconi
author_facet Alessandro Bergna
Jacques Megevand
Giacomo Mori
Leonardo Lenisa
Andrea Rusconi
author_sort Alessandro Bergna
collection DOAJ
description <b>Background and Clinical Significance</b>: Recto-vaginal fistulae (RVF) and fecal incontinence (FI) pose significant challenges for colorectal surgeons. Various therapeutic options have been proposed for each condition over time. Despite its procedural complexity and the risk of complications, graciloplasty remains a viable therapeutic option for both conditions, with favorable long-term results. To our knowledge, this is the first report of a case where the need to treat both conditions concurrently arose. <b>Case Presentation</b>: We report the case of a 54-year-old woman with severe FI and repeatedly operated on recurrent recto-vaginal fistula. The patient underwent graciloplasty to provide healthy tissue with an adequate vascular supply to both enhance the healing process of the fistula and reshape the anal canal with a circular muscular structure. Following the procedure, the patient experienced prompt symptom resolution and good clinical and functional recovery at a 1-year follow-up evaluation. <b>Conclusions</b>: This case report highlights the safety and effectiveness of an overlooked procedure for the treatment of large sphincter defects and concurrent recto-vaginal or recto-vaginal tears.
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spelling doaj-art-42c43d8d8fb147b99ce6ee57ba2c131c2025-08-20T03:43:40ZengMDPI AGReports2571-841X2025-01-01811110.3390/reports8010011The Role of Graciloplasty in the Treatment of Obstetric Anal Sphincter Injury with Subsequent Fecal Incontinence and Recurrent Low Recto-Vaginal Fistula: A Case ReportAlessandro Bergna0Jacques Megevand1Giacomo Mori2Leonardo Lenisa3Andrea Rusconi4Department of General Surgery, Humanitas San Pio X, 20159 Milan, ItalyDepartment of General Surgery, Humanitas San Pio X, 20159 Milan, ItalyDepartment of General Surgery, Humanitas Clinical and Research Center, 20089 Rozzano, ItalyDepartment of General Surgery, Humanitas San Pio X, 20159 Milan, ItalyDepartment of General Surgery, Humanitas San Pio X, 20159 Milan, Italy<b>Background and Clinical Significance</b>: Recto-vaginal fistulae (RVF) and fecal incontinence (FI) pose significant challenges for colorectal surgeons. Various therapeutic options have been proposed for each condition over time. Despite its procedural complexity and the risk of complications, graciloplasty remains a viable therapeutic option for both conditions, with favorable long-term results. To our knowledge, this is the first report of a case where the need to treat both conditions concurrently arose. <b>Case Presentation</b>: We report the case of a 54-year-old woman with severe FI and repeatedly operated on recurrent recto-vaginal fistula. The patient underwent graciloplasty to provide healthy tissue with an adequate vascular supply to both enhance the healing process of the fistula and reshape the anal canal with a circular muscular structure. Following the procedure, the patient experienced prompt symptom resolution and good clinical and functional recovery at a 1-year follow-up evaluation. <b>Conclusions</b>: This case report highlights the safety and effectiveness of an overlooked procedure for the treatment of large sphincter defects and concurrent recto-vaginal or recto-vaginal tears.https://www.mdpi.com/2571-841X/8/1/11ano-vaginal fistularecto-vaginal fistulaobstetric anal sphincter injuryfecal incontinencegraciloplastycase report
spellingShingle Alessandro Bergna
Jacques Megevand
Giacomo Mori
Leonardo Lenisa
Andrea Rusconi
The Role of Graciloplasty in the Treatment of Obstetric Anal Sphincter Injury with Subsequent Fecal Incontinence and Recurrent Low Recto-Vaginal Fistula: A Case Report
Reports
ano-vaginal fistula
recto-vaginal fistula
obstetric anal sphincter injury
fecal incontinence
graciloplasty
case report
title The Role of Graciloplasty in the Treatment of Obstetric Anal Sphincter Injury with Subsequent Fecal Incontinence and Recurrent Low Recto-Vaginal Fistula: A Case Report
title_full The Role of Graciloplasty in the Treatment of Obstetric Anal Sphincter Injury with Subsequent Fecal Incontinence and Recurrent Low Recto-Vaginal Fistula: A Case Report
title_fullStr The Role of Graciloplasty in the Treatment of Obstetric Anal Sphincter Injury with Subsequent Fecal Incontinence and Recurrent Low Recto-Vaginal Fistula: A Case Report
title_full_unstemmed The Role of Graciloplasty in the Treatment of Obstetric Anal Sphincter Injury with Subsequent Fecal Incontinence and Recurrent Low Recto-Vaginal Fistula: A Case Report
title_short The Role of Graciloplasty in the Treatment of Obstetric Anal Sphincter Injury with Subsequent Fecal Incontinence and Recurrent Low Recto-Vaginal Fistula: A Case Report
title_sort role of graciloplasty in the treatment of obstetric anal sphincter injury with subsequent fecal incontinence and recurrent low recto vaginal fistula a case report
topic ano-vaginal fistula
recto-vaginal fistula
obstetric anal sphincter injury
fecal incontinence
graciloplasty
case report
url https://www.mdpi.com/2571-841X/8/1/11
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