A case of recto-vaginal obstetrical fistula treated by the Martius lamp, seen at Befelatanana Madagascar
Abstract
The rectovaginal fistulas are a pathological epithelialized communication between the vagina and the rectum, its frequency is 10 to 30%, and it is a disabling pathology because of the social repercussion. Many flap techniques have been described but the aim is to present a simple procedure according to a particular technique called Martius. This is a case of woman presenting a low rectovaginal fistula on obstetrical trauma. The surgical technique consists of a repair according to the technique of Martius. The operative follow-up was simple and the patient was able to resume sexual activity and normal anal sphincter function. It is a simple technique, easy to achieve for the technical platform in Madagascar whose evaluation of the results for a larger population should be considered. This technique therefore deserves to be known and widely used.
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Manaouil D, Dumont F, Regimbeau JM, Duval H, Brazier F, Dupas JL, et al. Acquired rectovaginal fistulas of the adult. Gastroenterol Clin Biol. 2004;28:1267-79.
WHO. 10 facts on obstetric fistula. Geneva: World Health Organization; 2014. Available at: http://www.who.int/features/factfiles/obstetric_fistula/en/. Accessed on 10th August 2019.
De Bernis L. Obstetric fistula: guiding principles for clinical management and programme development. World Health Organization; 2006.
Sonoda T, Hull T, Piedmont MR, Fazio VW. Outcomes of primary repair of anorectal and rectovaginal fistulas using the endorectal advancement flap. Say Colon Rectum. 2002;45:1622-8.
Faucheron JL, Brugere Ch, Lisik F. The flap of Martius: surgical technique. J Chir. 2006;143:5.
Tebeu PM, Fomulu JN, Khaddaj S, Bernis L, Delvaux T, Rochat CH. Risk factors for obstetric fistula: a clinical review. Int Urogynecol J. 2012;23(4):387-94.
Claude D, Ludovic F. Surgical management of obstetric fistulae Bull. Acad Natle Med. 2012;196(8):1535-56.
Aartsen EJ, Sindram IS. Repair of the radiation-induced rectovaginal fistulas with interposition of the bulbocavernosus muscle (Martius procedure). Eur J Surg Oncol. 1988;14(2):171-7.
Falandry L, Lahaye F, Marara C. The cutaneous pedicled flap fat of the large lip in the treatment of complex vesico-vaginal fistulas. About 11 cases. J Urol (Paris); 1990:96(2):97-102.