A vaginal mucosal pedicle flap technique for repair of rectovaginal fistula in mares.
Abstract: To describe the use of a vaginal mucosal pedicle flap for repair of rectovaginal fistulae (RVF) in mares. Methods: Clinical case report. Methods: Three mares with RVF. Methods: After debriding the RVF, a dorsally based U-shaped mucosal and submucosal pedicle flap (2-4 mm thick) was dissected from the vaginal wall, rotated approximately 90 degrees angle to close the ventral aspect of the fistula and sutured in position with 10-13 single sutures that did not penetrate the rectal mucosa. This positioned the vaginal mucosa so that it was continuous with the rectal mucosa. Results: Two RVF healed by 1st intention whereas for the 3rd RVF, 2 additional single sutures were required to repair partial dehiscence after 10 days. At 6 weeks and 6 months all RVF were healed. One mare subsequently foaled without complications. Conclusions: RVF can be closed by use of a rotation flap of vaginal tissue. Conclusions: Tension-free closure of RVF can be achieved by rotating a pedicle flap of vaginal mucosal tissue without undue wound tension, and should be considered as an alternative to conventional appositional techniques.
Publication Date: 2004-09-15 PubMed ID: 15362990DOI: 10.1111/j.1532-950x.2004.04071.xGoogle Scholar: Lookup
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Summary
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This paper details a technique of using a vaginal mucosal pedicle flap to successfully repair rectovaginal fistulae in mares.
Objective and Methods
- The primary objective of this research was to explore and describe the use of a flap derived from vaginal tissue, more specifically the mucosa and submucosa, for repairing rectovaginal fistulae (RVF) in mares.
- The researchers treated three mares with this condition using the said technique. The RVF was first debrided, after which a U-shaped flap of the vaginal wall, 2-4 mm thick, was dissected. The flap was then rotated by about 90 degrees in order to close the cavity of the fistulae.
- The rotated flap was held in place using 10-13 individual sutures. These sutures, crucially, did not penetrate into the lining of the rectum. This positioning ensured that the lining of the vagina was now continuous with that of the rectum.
Results
- The findings of the study illustrated that this approach was largely successful. Two of the three mares healed through primary intention, indicating the wound closed without any complication after the initial procedure.
- The third mare experienced a complication in the form of partial dehiscence—a rupture along the surgical wound—ten days after the surgery. This was addressed by applying two additional sutures.
- The follow-up examination done at 6 weeks and then 6 months showed that all RVF had healed completely in all three mares.
- Moreover, one of the mares was able to successfully give birth without any complications after the procedure, hinting at the possibility of the endurance of fertility post-surgery.
Conclusions
- The results suggest that using a rotation flap of vaginal tissue can effectively close the RVF in mares.
- Rather than potentially tension-bearing techniques, employing a rotation flap of vaginal mucosal tissue to patch the RVF results in tension-free closure, which may reduce the chance of dehiscence and provide a more effective alternative to traditional appositional techniques.
Cite This Article
APA
Schönfelder AM, Sobiraj A.
(2004).
A vaginal mucosal pedicle flap technique for repair of rectovaginal fistula in mares.
Vet Surg, 33(5), 517-520.
https://doi.org/10.1111/j.1532-950x.2004.04071.x Publication
Researcher Affiliations
- Ambulatory and Obstetrical Veterinary Clinic, University of Leipzig, An den Tierkliniken, Leipzig, Germany. aschoenf@rz.uni-leipzig.de
MeSH Terms
- Animals
- Diagnosis, Differential
- Female
- Horse Diseases / diagnosis
- Horse Diseases / pathology
- Horse Diseases / surgery
- Horses
- Rectovaginal Fistula / diagnosis
- Rectovaginal Fistula / surgery
- Rectovaginal Fistula / veterinary
- Surgical Flaps / veterinary
- Vagina / surgery
Citations
This article has been cited 1 times.- Sharshar A, Hammad A, Salem M, El-Sunsafty M. Evaluation of a modified one-stage technique for repair of third-degree perineal laceration and rectovestibular fistula with rectal pull-back technique in 12 mares: a retrospective case series. BMC Vet Res 2025 Sep 17;21(1):538.
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