24 iul. 2008 FISTULA RECTOVAGINALA JOASA DE ORIGINE OBSTETRICALA
N. Constantea*, F. Jianu*, Ramona Morar**, V. Dudric*, Corina Capalneanu*
* Clinica Chirurgie V, UMF şIuliu Hatieganuş, Cluj-Napoca
** Clinica Obst. Ginecol. “Dominic Stanca” UMF “Iuliu Hatieganu”, Cluj-Napoca
Rezumat
Fistula rectovaginala (FRV) reprezinta o comunicare anormala intre suprafetele epiteliale ale vaginului si rectului, patologie cu implicatii majore pentru femeile tinere din punct de vedere fizic, psihic, social si sexual. FRV este o conditie patologica rara care recunoaste multiple cauze dintre care cea mai frecventa pare a fi cea obstreticala. In literatura sunt descrise mai multe tipuri de tratament chirurgical fiecare dintre ele fiind cotate cu rate variabile de succes. Studiile prezente sunt foarte heterogene, analizeaza un numar redus de paciente cu FRV de etiologie diferita ceea ce impiedica efectuarea unor comparatii valide intre modalitatile de tratament.
Dorim sa prezentam cazul unei paciente tinere cu FRV aparuta postpartum la 2 saptamani dupa nasterea vaginala cu evolutie de aproximativ 7 ani pentru care s-a ales ca modalitate de tratament abordul transvaginal cu evolutie postoperatorie simpla fara recidiva la 11 luni postoperator.
Abstract
The recto-vaginal fistula (FRV) represents an abnormal communication among the epithelial surfaces of the vagina and rectum, pathology with major physical, psychical, social and sexual implications for young women. FRV is a rare pathological condition, which has a lot of causes, the most frequent seems to be the obstetrical one. There are more types of surgical treatments described in literature, each of them rates with variable success. The present studies are very heterogenous, they analyze a reduced number of patients with FRV of different etiology and this hinders the making of valid comparisons of treatment possibilities.
We wish to present the case of a young patient with FRV, that appeared postpartum in 2 weeks after the vaginal birth with an evolution of approximately 7 years; the chosen treatment was the transvaginal approach with simple postoperative evolution without relapse in 11 months after the operation.