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BMC veterinary research2025; 21(1); 538; doi: 10.1186/s12917-025-04824-7

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.

Abstract: This study was carried out to evaluate a rectal pull-back one-stage technique, which is a modification of the one-stage Goetz technique, for treating third-degree perineal laceration or rectovestibular fistula. Methods: This study was performed on 12 mares, ten of whom suffered from third-grade perineal laceration, and two suffered from rectovestibular fistula and were included in this study. After incision of the vestibular shelf horizontally, the dissected rectal flap was pulled caudally and sutured to the anal sphincter during its reconstruction at the final stage. While the vestibular shelf/vaginal flap was reconstructed using size 2 polyglactin 910 suture material in six-bite suture pattern. Post-oparative follow up included monitoring the wound healing and recording the complications. Results: Neither necrosis of the rectovestibular shelf nor formation of rectovestibular fistula has been recorded. Two mares showed partial dehiscence of the perineal body and one had partial dehiscence of anal sphincter which healed successfully. Conclusions: Rectal pull-back technique can be a good alternative for the treatment of third-grade perineal laceration and rectovestibular fistula in mares.
© 2025. The Author(s).
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Publication Date: 2025-09-17 PubMed ID: 40963117PubMed Central: PMC12442302DOI: 10.1186/s12917-025-04824-7Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Research Overview

  • This study evaluated a modified one-stage surgical technique called the rectal pull-back technique for repairing severe third-degree perineal lacerations and rectovestibular fistulas in mares.
  • The results suggested this approach could be an effective alternative to traditional methods, demonstrating good healing outcomes with minimal complications.

Background and Purpose

  • Third-degree perineal laceration is a severe injury to the perineal area in mares that involves tearing of the rectum, anal sphincter, and vagina, often leading to complications such as rectovestibular fistulas (abnormal connections between the rectum and vestibule).
  • Conventional surgical repair can be complex due to anatomical challenges and high risk of postoperative complications.
  • The study aimed to evaluate a modified surgical technique—a rectal pull-back one-stage procedure, which builds upon the well-known Goetz technique—to improve outcomes in affected mares.

Study Design and Methods

  • Type of Study: Retrospective case series involving 12 mares.
  • Subjects:
    • 10 mares with third-degree perineal lacerations.
    • 2 mares with rectovestibular fistulas.
  • Surgical Technique:
    • Performed a horizontal incision of the vestibular shelf (portion of the vaginal vestibule).
    • Dissected a flap of rectal tissue, which was then pulled caudally (toward the tail) and sutured to the anal sphincter as part of the reconstruction.
    • Reconstructed the vestibular shelf/vaginal flap using size 2 polyglactin 910 suture arranged in a six-bite suture pattern to ensure strength and stability.
  • Postoperative Care and Assessment:
    • Monitored wound healing progression.
    • Recorded any complications such as tissue necrosis, fistula formation, or suture dehiscence (wound reopening).

Results

  • No cases of tissue necrosis in the rectovestibular shelf were observed, indicating good tissue viability after surgery.
  • No rectovestibular fistula formation was recorded during the follow-up period, suggesting effective closure and fistula prevention.
  • Complications:
    • Two mares experienced partial dehiscence of the perineal body (area between the anus and vagina), but these healed successfully with appropriate management.
    • One mare had partial dehiscence of the anal sphincter, which also healed successfully.

Conclusions and Clinical Implications

  • The rectal pull-back one-stage technique provides a promising alternative to traditional multiple-stage or Goetz technique surgeries for repairing third-degree perineal lacerations and rectovestibular fistulas in mares.
  • This method minimizes the risk of common complications such as tissue necrosis and fistula recurrence, while promoting effective wound healing.
  • The successful healing even in cases with minor wound dehiscence supports the technique’s reliability.
  • Veterinary surgeons dealing with these challenging equine injuries might consider adopting this modified approach to improve surgical outcomes and reduce postoperative complications.

Cite This Article

APA
Sharshar A, Hammad A, Salem M, El-Sunsafty M. (2025). 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, 21(1), 538. https://doi.org/10.1186/s12917-025-04824-7

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 21
Issue: 1
Pages: 538
PII: 538

Researcher Affiliations

Sharshar, Ahmed
  • Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.
Hammad, Amal
  • Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, 32511, Egypt.
Salem, Mohamed
  • Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.
El-Sunsafty, Mohamed
  • Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, 32511, Egypt. mohamed.gamal@vet.usc.edu.eg.

MeSH Terms

  • Animals
  • Female
  • Horses / injuries
  • Horses / surgery
  • Perineum / surgery
  • Perineum / injuries
  • Retrospective Studies
  • Lacerations / veterinary
  • Lacerations / surgery
  • Rectovaginal Fistula / surgery
  • Rectovaginal Fistula / veterinary
  • Horse Diseases / surgery
  • Surgical Flaps / veterinary
  • Wound Healing

Conflict of Interest Statement

Declarations. Ethical approval: All procedures were approved by the Animal Care and Use Committee, University of Sadat City–Faculty of Veterinary Medicine, Sadat City, Egypt (Ethical approval number: VUSC-008-1-24). All methods were performed in accordance with the relevant guidelines and regulation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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