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  • Title: Surgical approaches to postobstetrical perineal body defects (rectovaginal fistula and chronic third and fourth-degree lacerations).
    Author: Delancey JO, Berger MB.
    Journal: Clin Obstet Gynecol; 2010 Mar; 53(1):134-44. PubMed ID: 20142650.
    Abstract:
    Rectovaginal fistulas and chronic anal sphincter lacerations are uncommon complications that are most often secondary to vaginal delivery, gynecologic surgery, and inflammatory bowel disease. In this chapter, we will review the pertinent anatomy, focusing on the 6 structures that should be considered during the repair and surgical techniques to promote restoration on normal anatomy and function. Key concepts include a tension-free repair, meticulous hemostasis, and postoperative bowel management.
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