DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193073

Vagino-cutaneous fistula: unreported, under-reported or unheralded?

Ashwath Narayan Ramji

Abstract


Fistulas are communicating tracts between two surfaces, linking structures and planes that should, under normal circumstances, not be in dialogue. They may be congenital or acquired and are most commonly associated with the gastrointestinal and ano-rectal territories, where they link two different organ systems internally, or track outwards, creating a communicating channel between the internal viscera and the skin surface. Vaginal fistulas on occasion result from perineal tears due to traumatic delivery, or less commonly, infection or non-healing of the episiotomy wound, and are of the rectovaginal or vesicovaginal variety. Very rarely, the channel from the vagina tracks to an opening in the skin. This is the report of a patient who developed the rare vagino-cutaneous fistula following a normal vaginal delivery with episiotomy, and review of the limited literature available about the peculiar entity, so rare that no previous reports of vagino-cutaneous fistulas developing after vaginal delivery with episiotomy could be found.


Keywords


Episiotomy, Fistula, Obstetric fistula, Perineal fistula, Vagino-cutaneous fistula, Vaginal fistula

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References


Barranger E, Haddad B, Paniel BJ. Fistula in ano as a rare complication of mediolateral episiotomy: Report of three cases. Am J Obstet Gynecol. 2000;182(3):733-4.

Rogers RG, Jeppson, PC. Current Diagnosis and Management of Pelvic Fistulae in Women. Obstet Gynecol. 2016;128(3):635-50.

Polan ML, Sleemi A, Bedane MM, Svjetlana L, Mark AM. Obstetric Fistula. Chapter 6. In: Debas HT, Donkor P, Gawande A, Dean TJ, Margaret EK, Charles NM. Essential Surgery: Disease Control Priorities. 3rd Ed. Washington (DC): The International Bank for Reconstruction and Development / The World Bank. 2015;1.

Brown HW, Wang L, Bunker CH, Lowder JL. Lower reproductive tract fistula repairs in inpatient US women, 1979-2006. Int Urogynecol J. 2012;23(4):403-10.

Dorairajan G, Hima Bindu N (2014). Chronic non-healing sinus manifesting in episiotomy scar: Hidden fistula-in-ano. Int Urogynaecol J. 2014;25(10):1441-3.

World Health Organization. 2019. 10 facts on obstetric fistula. [online] Available at: https://www.who.int/features/factfiles/obstetric_fistula/en/

Sahin, A, Ilbey, Y, Sahin, N. Vaginocutaneous fistula and inguinal abscess presented 6 years after tension-free vaginal tape sling. Archivio Italiano Di Urologia E Andrologia. 2013;85(2):104-6.

Marques AL, Aparício C, Negrão L. Perineal cellulitis as a late complication of trans-obturator sub-urethral tape, Obtape. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(7):821-2.

Lowman J, Moore RD, Miklos JR. Tension-free vaginal tape sling with a porcine interposition graft in an irradiated patient with a past history of a urethrovaginal fistula and urethral mesh erosion: a case report. J Reprod Med. 2007;52(6):560-2.

Beksac K, Turgal M, Basaran D, Aran O, Beksac MS. (2014) Vaginoperineal Fistula as a Complication of Perianal Surgery in a Patient with Sjögren’s Syndrome: A Case Report. Case Reports in Rheumatology. Volume 2014, Article ID 359605. Available at: http://dx.doi.org/10.1155/2014/359605.

Giles DL, Davila GW. Suprapubic-Vaginocutaneous Fistula 18 Years After a Bladder-Neck Suspension. Obstet Gynecol. 2005;105(5):1193-5.

Maffiolini M, Asteria CR. A cutaneous-vaginal fistula and myositis of the obturator muscle following placement of a trans-obturator tape for stress incontinence. Euro J Obstet Gynecol Reprod Biol. 2010;149(2):225-6.

Abdallah A, Nisolle M, de Landsheere, L. Vaginocutaneous fistula and buttock abscess formation 7 years after polypropylene transobturator tape insertion. J Gynecol Obstet Human Repro. 2017;46(1):103-5.