Recto-vaginal fistulas. Recommendations of the Polish Club of Coloproctology Scientific Society

Recommendations that follow describe the etiology and classification of rectovaginal fistulas and, first and foremost, present the guidelines for surgical management thereof. Techniques used in the management of fistulas located within the lower part of the rectum include fistular lumen resection and layered closure of the resulting tissue loss, including reconstruction of the anal sphincter apparatus. TachoSil collagen-fibrin composite matrix is used to reinforce the reconstructed tissues. In the case of high rectovaginal fistulas, the affected intestinal segment is resected along with the fistular mouth with simultaneous or delayed restoration of gastrointestinal continuity.