Number №2, 2020 - page 130-135

The experience of multi-stage surgical rehabilitation of a patient with a radial vesicovaginal and rectal fistula: a clinical case DOI: 10.29188/2222-8543-2020-12-2-130-134

For citation: Eliseev D.E., Kholodova J.L., Abakumov R.S., Atroshchenko A.O., Kachmazov A.A., Bekiev Ya.D., Sidorov D.V., Chernikova E.N. The experience of multi-stage surgical rehabilitation of a patient with a radial vesicovaginaland rectal fistula: a clinical case. Experimental and clinical urology 2020;(2):136-141
Serebryanyy S.A., Kachmazov A.A., Grigor'ev A.A., Maslov S.A., Polyakov N.V., Alekseev B.Ya.
Information about authors:
  • Eliseev D.E. – physician of the Group of Companies «SM-Clinic»; physician of the gynecological department with oncological beds of «Clinical Hospital» of the presidential administration RF, Moscow; ORCID 0000-0002-0270-7515
  • Kholodova Zh.L. – PhD, head of the gynecological department with oncological beds of «Clinical Hospital» of the presidential administration RF;
  • Abakumov R.S. – physician of the gynecological department with oncological beds of «Clinical Hospital» of the presidential administration RF; ORCID 0000-0003-1339-3870
  • Atroshchenko A.O. – PhD, head of coloproctology department with oncological beds of «Clinical Hospital» of the presidential administration RF, ORCID 0000-0002-8629-8252
  • Kachmazov A.A. – PhD, head of the oncological department f N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation
  • Bekiev Ya.D. – PhD, head of the urological department f N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation
  • Sidorov D.V. – Dr. Sci., Head of the Abdominal Surgical Department of Moscow P. Hertsen MORI Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation
  • Chernikova E.N. – physician of the department of operative endoscopy of A.S. Loginov Moscow Clinical Scientific Center
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Introduction. Genital fistulas remain to be one of the most complicated and not completely resolved problems of urogynecology and pelvic surgery. Despite the fact, that over the past 30 - 40 years the number of «obstetric» fistulas has significantly decreased, the proportion of traumatic «gynecological» and postradiation fistulas has increased. The main challenge for performing reconstructive surgery for fistulas after radiation are tissue circulation disturbances, a progressive decrease in the capacity of the bladder with an outcome in microcystis and a narrowing of the rectum at the level of the rectovaginal fistula due to a scar «spur», which often forms in the region of the posterior rectal wall after exposure to radiation therapy.

Case report. The article presents a clinical case of a complex vesico-vaginal-rectal fistula in a 45-year-old patient who required a multi-stage surgical treatment.

Discussion. Currently, the possibilities of reconstructive surgery allow to restore urination and defecation in many patients with complex and combined genital fistulas. But for pelvic surgeons, who are competent in the treatment of this complex category of patients, training is needed.

Conflict of interest. The authors declare no conflict of interest.

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