Practice patterns regarding management of rectovaginal fistulae: a multicenter review from the Fellows' Pelvic Research Network
| Autor: | Nicole M. Book, K.A. Greene, Cynthia S. Fok, Heidi S. Harvie, Rachel N. Pauls, Monica L. Richardson, Joy A. Greer, Amos Adelowo, Susan H. Oakley, Fiona M. Lindo, Ladin A. Yurteri-Kaplan, Leon N. Plowright, Heidi W. Brown, Cristina M. Saiz |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Urology Remission Spontaneous Fistulectomy Article Interquartile range Medicine Humans Medical history Practice Patterns Physicians' Retrospective Studies Gynecology Practice patterns business.industry Crohn disease Rectovaginal Fistula Obstetrics and Gynecology Treatment options Retrospective cohort study Middle Aged Surgery Treatment Outcome Obstetric trauma Female business |
| Zdroj: | Female pelvic medicinereconstructive surgery. 21(3) |
| ISSN: | 2154-4212 |
| Popis: | OBJECTIVES Rectovaginal fistulae (RVFs) are often debilitating and there are no established treatment algorithms. We sought to describe current diagnosis and management strategies for RVFs across the United States. METHODS This institutional review board-approved multicenter retrospective study included 12 sites. Cases were identified using International Classification of Diseases, Ninth Revision codes during a 5-year period. Demographics, management, and outcomes of RVF treatment were collected. RESULTS Three hundred forty-two charts were identified; 176 (52%) met criteria for inclusion. The mean (SD) age was 45 (17) years. Medical history included hypertension (21%), cancer (17%), Crohn disease (11%), and diabetes (7%). Rectovaginal fistulae were often associated with obstetric trauma (42%), infection/inflammation (24%), and cancer (11%). Overall, most RVFs were primary (94%), small (0.5-1.5 cm; 49%), transsphincteric (31%), and diagnosed via vaginal and rectal (60%) examination. Eighteen percent (32/176) were initially managed conservatively for a median duration of 56 days (interquartile range, 29-168) and 66% (21/32) of these resolved. Almost half (45%) of RVFs treated expectantly were tiny ( |
| Databáze: | OpenAIRE |
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