TY - JOUR
T1 - Martius fat pad flap procedure for management of obstetric rectovaginal fistula
T2 - A case report
AU - Hadi, Tri Hastono Setyo
AU - Hardianto, Gatut
AU - Kurniawati, Eighty Mardiyan
AU - Parathon, Harry
AU - Putra, M. Dimas Abdi
AU - Wahyuningtyas, Riska
AU - Rahmatyah, Rizqy
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/9
Y1 - 2023/9
N2 - Obstetric trauma is a risk factor for rectovaginal fistula, and it is a challenge for both patients and surgeons. In this case report, we describe the surgical technique of the Martius fat pad flap for repair of a rectovaginal fistula. The patient was a 30-year-old woman, para 1, with a previous spontaneous vertex vaginal delivery of a 2500-g male baby at 37 weeks of gestation. There was a history of arrest of descent, and the patient had a third-degree perineal laceration that was repaired in the operating room. Twelve days after delivery, the patient complained about fecal vaginal discharge and was diagnosed with a rectovaginal fistula. Physical examination revealed a rectovaginal fistula with a 2 cm diameter and located 1 cm from the hymen. The tone of the external anal sphincter was within normal limits, which was confirmed with transperineal ultrasound scan. The repair was done 3 months after the previous repair in order to allow for the restoration of tissue integrity and the complete healing of the previous wound. The rectovaginal fistula was repaired with a Martius fat pad flap in a transperineal approach. After 60 days of follow-up, the wound involving the labia majora and the fistula were healed completely.
AB - Obstetric trauma is a risk factor for rectovaginal fistula, and it is a challenge for both patients and surgeons. In this case report, we describe the surgical technique of the Martius fat pad flap for repair of a rectovaginal fistula. The patient was a 30-year-old woman, para 1, with a previous spontaneous vertex vaginal delivery of a 2500-g male baby at 37 weeks of gestation. There was a history of arrest of descent, and the patient had a third-degree perineal laceration that was repaired in the operating room. Twelve days after delivery, the patient complained about fecal vaginal discharge and was diagnosed with a rectovaginal fistula. Physical examination revealed a rectovaginal fistula with a 2 cm diameter and located 1 cm from the hymen. The tone of the external anal sphincter was within normal limits, which was confirmed with transperineal ultrasound scan. The repair was done 3 months after the previous repair in order to allow for the restoration of tissue integrity and the complete healing of the previous wound. The rectovaginal fistula was repaired with a Martius fat pad flap in a transperineal approach. After 60 days of follow-up, the wound involving the labia majora and the fistula were healed completely.
KW - Martius fat pad flap
KW - Obstetric rectovaginal fistula
KW - Transperineal repair
UR - http://www.scopus.com/inward/record.url?scp=85172291661&partnerID=8YFLogxK
U2 - 10.1016/j.crwh.2023.e00547
DO - 10.1016/j.crwh.2023.e00547
M3 - Article
AN - SCOPUS:85172291661
SN - 2214-9112
VL - 39
JO - Case Reports in Women's Health
JF - Case Reports in Women's Health
M1 - e00547
ER -