Patient's question:
1 Patient is female, two and a half months post-surgery. The surgery was performed at Qilu Hospital in May (anal correction, perineal fistula repair). It has been 40 days since the surgery. In the past few days, she noticed that there was some leakage again at the upper outer side of the perineum, with partial fecal leakage.2 Upon waking up, there is some initial straining during urination (some time after the catheter was removed post-surgery).
Doctor's answer:
Rectal-vaginal fistula is complex in etiology, diverse in types, prone to postoperative infection, and has a high recurrence rate. Additionally, the surgical difficulty is significant, making it crucial to choose the appropriate surgical approach to achieve a single successful outcome. For patients with congenital anorectal malformations and rectal-vaginal fistula, the following should be noted: ① surgical approach and operative techniques; ② whether the terminal rectum is sufficiently freed; ③ avoiding severe infection; ④ fully releasing the terminal rectal mucosa to ensure tension-free suture.