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Int J Med Robot 2019 Apr 24:e2001. Epub 2019 Apr 24.

Department of General Surgery and Colorectal Surgery at the George Washington University Hospital, Washington, DC.

Purpose/background: Using robotic surgery, we report successful resection of deep invasive pelvic endometriosis with a multidisciplinary team of colorectal and gynecologic surgeons.

Methods/interventions: Fifteen cases of robotic assisted endometrial resections for deep invasive endometriosis were performed by a multidisciplinary team between 2013 and 2016.

Results/outcomes: The average total operative time of robotic endometrial extirpation was 342 minutes and the average blood loss was 283 cc. Read More

BMJ Case Rep 2019 Apr 14;12(4). Epub 2019 Apr 14.

Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Vaginal pessary is a practical and effective tool for pelvic organ prolapse management. Nevertheless, serious complications can occur in neglected patients such as vesicovaginal and rectovaginal fistula, erosion and impaction in adjacent structures. We report a case of neglected pessary found in the uterine cavity. Read More

J Obstet Gynaecol Can 2019 Apr 12. Epub 2019 Apr 12.

Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA; Center for Surgery and Public Health,(,) Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Objective: Obstetric fistulas have a significant physical and social impact on many women in Angola. The majority of the population of this sub-Saharan African nation does not have access to high-quality obstetric care, and this is associated with a risk of prolonged labour and formation of obstetric fistulas. Fistulas are challenging to correct surgically and may require repeated operations. Read More

Tech Coloproctol 2019 Apr 1. Epub 2019 Apr 1.

Colorectal Unit, Department of Surgery, Michallon University Hospital, CS 10 217, 38 043, Grenoble cedex, France.

Background: The over-the-scope clip proctology system is rather new and information regarding its use for the closure of anorectal fistulas is scarce. No study has been designed to focus exclusively on its application in the treatment of rectovaginal fistulas. The aim of the study was to evaluate the feasibility, safety, and effectiveness of the clip for rectovaginal fistula repair. Read More

World J Gastroenterol 2019 Mar;25(11):1421-1431

Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.

Background: Obstructed defecation syndrome (ODS) is a widespread disease in the world. Rectocele is the most common cause of ODS in females. Multiple procedures have been performed to treat rectocele and no procedure has been accepted as the gold-standard procedure. Read More

JSLS 2019 Jan-Mar;23(1)

Department of Surgery, Iwate Medical University School of Medicine, Iwate Japan.

Background: Anastomotic leakage during laparoscopic low anterior resection (Lap-LAR) for rectal cancer remains challenging for colorectal surgeons. Firing linear staplers multiple times has been reported as a risk factor for iatrogenic anastomotic leakage. Our institute usually performs rectal transection using 2 planned stapler fires followed by anastomosis with the double-stapling technique. Read More

J Surg Case Rep 2019 Mar 12;2019(3):rjz001. Epub 2019 Mar 12.

Department of Gastrointestinal Surgery, Monterrey Institute of Technology and Higher Education, Nuevo Leon, Mexico.

Rectovaginal fistulas (RVF) are the cause of major affliction to the affected patient and are a foremost challenge for the attending surgeon. Traditional techniques for treatment of RVF are quite extensive and particularly invasive. A more local procedure, with an acceptable success rate, would be the ideal first approach in treatment of this particular ailment. Read More

J Cancer 2019 29;10(5):1103-1109. Epub 2019 Jan 29.

Department of Radiation Oncology, Xijing Hospital. The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.

: The optimal radiotherapy regimen for treating metastatic lymphadenopathy in patients with locally advanced cervical cancer remains controversial. This study aimed to investigate the clinical outcomes, as well as associated toxicities, of intensity-modulated radiotherapy (IMRT) with a simultaneous integrated boost (SIB) for pelvic and para-aortic lymph nodes (LNs). : Between 2011 and 2015, 74 patients with 2014 International Federation of Gynecology and Obstetrics stage IIB-IVB cervical cancer exhibiting pelvic or para-aortic LN involvement were examined. Read More

Female Pelvic Med Reconstr Surg 2019 Feb 28. Epub 2019 Feb 28.

From the Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY.

Objectives: This study aimed to characterize variations in female pelvic medicine and reconstructive surgery (FPMRS) fellows' surgical experiences, concurrence with Accreditation Council for Graduate Medical Education (ACGME) proposed procedural volume guidelines, and to explore how these factors affect self-assessed preparedness to practice independently upon graduation.

Methods: An electronic survey was sent to 166 fellows enrolled in ACGME-approved FPMRS fellowship programs during the 2017-2018 academic year. The survey included questions on demographics, program specifics, desires for future practice, case volume, and self-assessed ability to independently perform selected procedures. Read More

Best Pract Res Clin Obstet Gynaecol 2019 Jan 29. Epub 2019 Jan 29.

Department of Obstetrics and Gynecology, Hospital CHR Liège, University of Liège, Boulevard du 12eme de Ligne,1, 4000, Liège, Belgium. Electronic address:

The surgical management of bowel endometriosis is a real challenge. In addition to the fact that only symptomatic patients should undergo surgery, no consensus has been approved in the literature. Among the surgical techniques, the surgeon has to choose between rectal shaving, disc excision, or segmental colorectal resection. Read More

Gynecol Obstet Fertil Senol 2019 04 16;47(4):378-380. Epub 2019 Feb 16.

Department of Gynecology and Obstetrics, Tenon University Hospital, Assistance publique-des Hôpitaux de Paris (AP-HP), Sorbonne University, 75000 Paris, France; Groupe de recherche clinique 6 (GRC6-UPMC), centre expert en endométriose (C3E), 75020 Paris, France; UMR_S938 Sorbonne University, 75000 Paris, France.

Mymensingh Med J 2019 Jan;28(1):8-14

Dr Sangul Islam, Medical Officer, SOPD, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh.

The standard treatment of high variety anorectal malformation (ARM) is the staged approach. A growing interest in one stage correction of high variety ARM was noted recently. The aim of this study was to examine the feasibility, safety and outcome of single stage correction of High variety ARM. Read More

Colomb Med (Cali) 2018 Dec 30;49(4):261-264. Epub 2018 Dec 30.

Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud Departamento de Ciencias Clínicas. Monterrey, Nuevo León, México.

Introduction: There is a high rate of deliveries in adolescents in Mexico. This age group is vulnerable to obstetric complications, including lacerations of the anal sphincter.

Objective: To determine the prevalence of third and fourth degree perineal tears in adolescents during childbirth, and to evaluate risk factors in comparison with deliveries with lacerations of adult women. Read More

Gastroenterol Res Pract 2018 23;2018:5249087. Epub 2018 Dec 23.

Policlinico Tor Vergata, Department of Surgery, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.

Background: One-third of Crohn's disease (CD) patients present perianal fistula. The gold standard in the diagnosis and treatment of symptomatic perianal disease (PAD) in CD is the exploration of the anal canal and distal rectum under anesthesia (EUA). This procedure is mainly conducted as a day case surgery. Read More

Anticancer Drugs 2019 Apr;30(4):425-427

Department of Medical Oncology, ASST-Settelaghi, Circolo Hospital, Varese, Italy.

Renal cell carcinoma (RCC) is one of the most frequent malignancies of the adults. Its incidence has been increasing steadily by 2-4% each year. Up to 30% of patients present with metastases at diagnosis. Read More

Tech Coloproctol 2018 12 2;22(12):905-917. Epub 2019 Jan 2.

Centre Hospitalier Universitaire Haut Lévêque, Avenue Magellan, 33604, Pessac Cedex, France.

The French National Society of Coloproctology established national recommendations for the treatment of anoperineal lesions associated with Crohn's disease. Treatment strategies for acute abscesses, active fistulas (active denovo and still active under treatment), fistulas in remission, and rectovaginal fistulas are suggested. Recommendations have been graded following the international recommendations, and when absent, professional agreement has been established. Read More

Tech Coloproctol 2019 01 2;23(1):43-52. Epub 2019 Jan 2.

Department of Surgery, Caritas Clinic St. Josef, Landshuter Str. 65, 93053, Regensburg, Germany.

Background: The aim of this study was to evaluate the effectiveness of gracilis muscle transposition (GMT) to treat recurrent anovaginal, rectovaginal, rectourethral, and pouch-vaginal fistulas in patients with inflammatory bowel disease (IBD).

Methods: A retrospective study was conducted in patients with IBD who had GMT performed by a single surgeon between 2000 and 2018. Follow-up data regarding healing rate, complications, additional procedures, and stoma closure rate was collected. Read More

Int J Colorectal Dis 2019 Mar 28;34(3):551-554. Epub 2018 Dec 28.

Department of Pediatric Surgery, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.

Purpose: Persistent fecal incontinence beyond childhood is common in ARM patients. The aim of this study was to analyze a consecutive series of adult patients with persistent incontinence, establish the causes, and evaluate whether further treatment could be offered.

Methods: Forty-four adult ARM patients with reported incontinence were invited. Read More

Diagn Interv Radiol 2019 Jan;25(1):21-27

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

Anal and perianal region is a commonly affected area in the course of several inflammatory, infectious, and neoplastic diseases. Several imaging modalities may be used in imaging evaluation of this area and magnetic resonance imaging (MRI) emerges as the imaging modality of choice due to its superb soft tissue resolution. MRI is not only useful for initial detection of anal/perianal pathologies but also in the follow-up of these disorders. Read More

Dis Colon Rectum 2019 02;62(2):223-233

Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Background: Long-term outcomes and efficacy of partial stapled hemorrhoidopexy are not known.

Objective: The purpose of this study was to compare the long-term clinical efficacy and safety of partial stapled hemorrhoidopexy with circumferential stapled hemorrhoidopexy.

Design: This was a parallel group, randomized, noninferiority clinical trial. Read More

Eur J Obstet Gynecol Reprod Biol 2019 Jan 6;232:46-53. Epub 2018 Nov 6.

Expert Center in the Diagnosis and Multidisciplinary Management of Endometriosis, Rouen University Hospital, Rouen, France; Clinique Tivoli-Ducos, Bordeaux, France. Electronic address:

Objective: Deep endometriosis may simultaneously infiltrate the vagina and the rectosigmoid, which associated resection may increase the risk of postoperative complications. Among these complications, rectovaginal fistula is one of the worst. To reduce the risk of rectovaginal fistula and related complications, surgeons may employ diverting stoma. Read More

J Crohns Colitis 2018 Nov 19. Epub 2018 Nov 19.

Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, (AP-HP), University Denis Diderot (Paris VII), Clichy, France.

Background & Aims: Faecal diversion (FD) can be proposed in patients with refractory anoperineal Crohn's disease (APCD). This study aimed to assess long-term results of this strategy, following the advent of the anti-TNF era.

Methods: All patients who underwent FD for refractory APCD between 2005 and 2017 were included, excluding patients with a history of ileal pouch-anal anastomosis. Read More

World J Clin Cases 2018 Oct;6(12):538-541

Department of Radiology, Medical University in Lublin, Lublin 20-081, Polen (POL), Poland.

Colovesical fistulas (CVFs) are rare complications of very advanced cancers of the abdominal or pelvic cavity and often cause diagnostic troubles. CVFs are found more often in males, whereas females usually suffer from rectovaginal or vesicovaginal fistulas. This article presents a case of a female patient who was admitted to the hospital because of acute diarrhea, presumably of infectious origin, and with only subtle abnormalities in blood tests and urinalysis. Read More

Gynecol Obstet Fertil Senol 2018 12 29;46(12):913-921. Epub 2018 Oct 29.

Service de gynécologie-obstétrique, hôpitaux de Nantes, CHU Hôtel-Dieu, 38, boulevard Jean-Monnet, 44000 Nantes, France; Université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France.

Objectives: The aim of this review was to agree on a definition of the obstetric anal sphincter injuries (OASIS), to determine the prevalence and risk factors.

Methods: A comprehensive review of the literature on the obstetric anal sphincter injuries (OASIS), establishment of levels of evidence (NP), and grades of recommendation according to the methodology of the recommendations for clinical practice.

Results: To classify obstetric anal sphincter injuries (OASIS), we have used the WHO-RCOG classification, which lists 4 degrees of severity. Read More

Pediatr Surg Int 2019 Jan 30;35(1):77-85. Epub 2018 Oct 30.

Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Purpose: Females with recto-vestibular fistula (RVF) can be managed either by one-stage sagittal anorectoplasty (SARP) or by conventional multi-stage approach with colostomy followed by SARP. Our aim was to define which approach, one-stage or multi-stage, is safer and more beneficial.

Methods: Using a defined search strategy, two investigators identified all comparative studies on the mentioned procedures. Read More

Trop Med Int Health 2019 Jan 18;24(1):53-64. Epub 2018 Nov 18.

Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, CA, USA.

Objectives: To explore trajectories of physical and psychosocial health, and their interrelationship, among women completing fistula repair in Uganda for 1 year post-surgery.

Methods: We recruited a 60-woman longitudinal cohort at surgical hospitalisation from Mulago Hospital in Kampala Uganda (Dec 2014-June 2015) and followed them for 1 year. We collected survey data on physical and psychosocial health at surgery and at 3, 6, 9 and 12 months via mobile phone. Read More

J Pediatr Adolesc Gynecol 2019 Feb 24;32(1):7-14. Epub 2018 Oct 24.

Nationwide Children's Hospital, Columbus, Ohio.

Patients born with complex anorectal malformations often have associated Müllerian anomalies, which might affect fertility and obstetrical outcomes. Other vertebral-anorectal-tracheoesophageal-renal-limb associations, such as renal or cardiac anomalies, could also affect pregnancy intention, fertility rates, and recommendations about mode of delivery or obstetrical outcomes. Associated conditions present at birth, like hydrocolpos, could also potentially affect fertility. Read More

ANZ J Surg 2018 Oct 22. Epub 2018 Oct 22.

Department of Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.

J Magn Reson Imaging 2018 Nov;48(5):1172-1184

Mayo Clinic Department of Radiology, Rochester, Minnesota, USA.

A wide variety of fistulae occur in the female pelvis, most of which cause significant morbidity. Diagnosis, characterization, and treatment planning may be difficult using traditional imaging modalities such as fluoroscopy and computed tomography. To date, there is no comprehensive literature review of the radiologic findings associated with various types of female pelvic fistulae, and furthermore, none dedicated to magnetic resonance imaging (MRI). Read More

Inflamm Bowel Dis 2018 Oct 19. Epub 2018 Oct 19.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.

Background: This study sought to re-estimate the cumulative incidence of perianal or rectovaginal fistulas and the associated proctectomy rate in the prebiologic era vs the biologic era using a population-based cohort of Crohn's disease (CD) patients.

Methods: The medical records of 414 residents of Olmsted County, Minnesota, who were diagnosed with CD between 1970 and 2010 were reviewed. The cumulative incidence of perianal or rectovaginal fistulas from time of CD diagnosis and the cumulative rate of proctectomy from date of first perianal or rectovaginal fistula diagnosis were estimated using the Kaplan-Meier method. Read More

Eur J Contracept Reprod Health Care 2018 Oct 16;23(5):387-389. Epub 2018 Oct 16.

a Department of Gynaecology , Taizhou First People's Hospital , Taizhou , China.

Case: Although many complications have been reported with intrauterine contraceptive devices (IUDs), vesicovaginal fistula with secondary vaginal stones is rare. We report the case of a 46-year-old woman who presented with a vaginal discharge lasting 2 months. Two years previously, she had undergone cystoscopic lithotripsy and surgery to remove an IUD, after pelvic radiography had revealed a fractured Chinese stainless steel ring IUD with secondary vesical stones that had been the cause of her urinary tract symptoms. Read More

Neurourol Urodyn 2019 Jan 12;38(1):407-416. Epub 2018 Oct 12.

International Organization of Physical Therapists in Women's Health, Burras Lynd, Otley, West Yorkshire, United Kingdom.

Aims: To discuss the role of physiotherapy in the management of women who have suffered an obstetric fistula, referring to research findings when appropriate and available, and the experiences of clinical specialists in the field.

Methods: The experiences of physiotherapists who have worked in countries where obstetric fistula is prevalent, and the limited literature available, were considered in producing this consensus document on behalf of the ICS Physiotherapy Committee.

Results: The role of physiotherapy both pre- and post-fistula repair was identified, and is multi-faceted. Read More

J Laparoendosc Adv Surg Tech A 2018 Oct 2. Epub 2018 Oct 2.

1 Division of Pediatric Surgery, Saitama Children's Medical Center , Saitama, Japan .

Aim: This study aimed to compare the surgical outcomes of patients with the intermediate-type imperforate anus who underwent laparoscopically assisted anorectoplasty (LAARP; L group) with those of patients who underwent sacroperineal anorectoplasty (S group).

Materials And Methods: The medical records of patients with intermediate-type imperforate anus at a single institution between April 1983 and April 2017 were retrospectively reviewed. Fecal continence was evaluated using the clinical assessment score for fecal continence developed by the Japanese Study Group of Anorectal Anomalies (maximum score, 8). Read More

Health Policy Plan 2018 Nov;33(9):999-1008

Department of Health Economics and Outcomes Research, Regeneron Pharmaceuticals, Tarrytown, NY, USA.

In Africa, about 33 000 cases of obstetric fistula occur each year. Women with fistula experience debilitating incontinence of urine and/or faeces and are often socially ostracized. Worldwide, Uganda ranks third among countries with the highest burden of obstetric fistula. Read More

Radiographics 2018 Sep-Oct;38(5):1385-1401

From the Department of Radiology (W.M.V., S.P.S., M.C.W., J.G.F.), Department of Surgery (A.L.L.), and School of Medicine (S.T.K.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).

Anorectal vaginal fistulas (ARVFs) can result in substantial morbidity and potentially embarrassing symptoms in adult women of all ages. Despite having what may be obvious clinical manifestations, the fistulas themselves can be difficult to identify with imaging. MRI is the modality of choice for the diagnosis and characterization of ARVFs. Read More

Surg Innov 2019 Feb 10;26(1):66-71. Epub 2018 Sep 10.

1 The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.

Purpose: This study is designed to assess the safety, efficacy, and postoperative outcomes of stapled transperineal repair in management of rectovaginal fistula (RVF).

Methods: A prospective database of patients with RVF undergoing stapled transperineal repair between May 2015 and December 2017 was established and studied retrospectively.

Results: Seven consecutive RVF patients underwent stapled transperineal repair. Read More

Rev Gastroenterol Peru 2018 Apr-Jun;38(2):196-200

Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú.

The repair of complex anorectal-vaginal fistulas represents an anatomic-surgical challenge for the surgeon, and the appropriate surgical procedure must be selected for each case. The procedure of Martius is described as the transposition of the bulbocavernosus muscle to repair the recto-vaginal fistula. Five cases of anorectal-vaginal fistulae were repaired by this procedure from 2010 to 2014. Read More

J Indian Assoc Pediatr Surg 2018 Jul-Sep;23(3):148-152

Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raibareli Road, Lucknow, Uttar Pradesh, India.

Aim And Objectives: Despite the significant advancements in the management of anorectal malformations (ARMs), there are various surgical and functional complications reported. Complications are closely related with the surgical techniques adopted and the types of malformations. In this article, we present our experiences with ARM patients who required reoperation after unsuccessful previous surgeries or who had developed complications related to the previous surgical techniques. Read More

Surg Innov 2018 Oct 12;25(5):450-454. Epub 2018 Jul 12.

1 St Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Background: The standard treatment of rectovaginal deep infiltrating endometriosis nodules (RVDIEN) consists in their surgical removal. RVDIEN are anatomically neovascularized. Indocyanine green (ICG) reveals vascularized structures when becoming fluorescent after exposure to near-infrared (NIR) light. Read More

Updates Surg 2018 Dec 7;70(4):485-490. Epub 2018 Jul 7.

Surgery of the Alimentary Tract, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.

Background: The surgical management of rectovaginal fistulae associated with Crohn's disease is often frustrated by poor results regardless of the different techniques. The outcomes of the gracilis muscle transposition (GMT) for the treatment of recurrent Crohn's-associated fistulae are still debated. The aim of the study is to determine whether the success rate of GMT is similar in Crohn's disease patients and in a control group. Read More

J Pediatr Surg 2018 Nov 1;53(11):2170-2173. Epub 2018 Jun 1.

Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, WC1N 3JH, UK; Stem Cells and Regenerative Medicine Section, DBC, Institute of Child Health, University College London, London, WC1N 1EH, UK. Electronic address:

Aim Of The Study: Divided colostomy (DC) has been recommended in anorectal malformations (ARMs) with previously reported advantages of decreasing overflow into the distal limb and urinary tract infections (UTIs). Skin bridge loop colostomy (LC) is a technically easier alternative without an increase in these complications. We report our institutional experience of LC in ARM. Read More

Updates Surg 2018 Dec 27;70(4):459-465. Epub 2018 Jun 27.

Department of General Surgery, Sacred Heart - Don Calabria Hospital, Via Don A. Sempreboni 5, 37024, Negrar, Verona, Italy.

The aim was to report our experience with delayed colo-anal anastomosis (DCA) to avoid permanent stoma for complex rectal cases evaluating short- and long-term outcomes. Nine patients who underwent DCA from 2011 to 2016 were collected and analysed case by case. We considered medical history and surgical outcomes. Read More

BMC Womens Health 2018 06 20;18(1):106. Epub 2018 Jun 20.

Department of Health Service Management and Health Economics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Background: Women with fistula live in a state of distress and in fear of their future life. An obstetric fistula has a devastating impact on affected women and their families. The objective of this systematic review was to synthesize the evidence from published articles on the consequences of obstetric fistula on women who endure the condition. Read More

Tech Coloproctol 2018 07 7;22(7):563. Epub 2018 Jun 7.

Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program, Messina University Medical School Hospital, Via Consolare Valeria, 98125, Messina, Italy.

Obstet Gynecol Int 2018 6;2018:5298214. Epub 2018 May 6.

Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey.

Aim: To assess the results of the treatment of rectovaginal fistulas with incontinence and impaired anal tonus.

Materials And Methods: This study comprised three rectovaginal fistula groups that were treated using sphincteroplasty and fistulectomy: group 1: eight women with simple rectovaginal fistula due to birth trauma; group 2: six rectovaginal fistula cases that were associated with chronic inflammatory diseases; and group 3: five cases with at least one failed repair attempt. In the second step, operations that took place before the year 2000 were compared to the operations that took place after the year 2000 in terms of demographic and clinical characteristics. Read More

Hum Reprod 2018 07;33(7):1205-1211

Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Festa del Perdono 7, Milan, Italy.

Bowel surgery for colorectal endometriosis is being promoted to infertile women without severe sub-occlusive symptoms, with the objective of improving the likelihood of conception. Contrary to rectal shaving, bowel surgery involving full-thickness disk excision and segmental resection entails opening of the intestinal lumen thus increasing the risk of postoperative infectious complications. About 1 in 10 patients undergoing colorectal resection for intestinal endometriosis will experience severe sequelae, including anastomotic dehiscence, rectovaginal fistula formation, and bladder and bowel denervation. Read More

J Clin Med 2018 Apr 22;7(4). Epub 2018 Apr 22.

Mayo Clinic Arizona; Phoenix, AZ 85054 USA.

Colovaginal and/or rectovaginal fistulas cause significant and distressing symptoms, including vaginitis, passage of flatus/feces through the vagina, and painful skin excoriation. These fistulas can be a challenging condition to treat. Although most fistulas can be treated with surgical repair, for those patients who are not operative candidates, limited options remain. Read More

Sultan Qaboos Univ Med J 2018 Feb 4;18(1):e107-e109. Epub 2018 Apr 4.

Department of Obstetrics & Gynaecology, Jordan Healthcare Centre, Amman, Jordan.

Rectovaginal after sexual intercourse are rare. We report a healthy recently married 21-year-old woman who presented to the Jordan Healthcare Centre, Amman, Jordan in 2014 with a five-week history of passing and stool from the vagina. Six weeks prior, she had sustained a rectovaginal injury during initial consensual sexual intercourse, leading to the development of a distal rectovaginal . Read More

Dis Colon Rectum 2018 Jun;61(6):733-742

Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital Bern, University of Bern, Switzerland.

Background: Curative management of deep infiltrating endometriosis requires complete removal of all endometriotic implants. Surgical approach to rectal involvement has become a topic of debate given potential postoperative bowel dysfunction and complications.

Objective: This study aims to assess long-term postoperative evacuation and incontinence outcomes after laparoscopic segmental rectal resection for deep infiltrating endometriosis involving the rectal wall. Read More