The challenge of pouch-vaginal fistulas: a systematic review

@article{Maslekar2012TheCO,
  title={The challenge of pouch-vaginal fistulas: a systematic review},
  author={Sushil Maslekar and P M Sagar and Deena P. Harji and C. Bruce and Ben Griffiths},
  journal={Techniques in Coloproctology},
  year={2012},
  volume={16},
  pages={405-414}
}
Pouch-vaginal fistulae affect 6 % of women after ileal pouch-anal anastomosis. Such fistulae significantly impact on the patient’s quality of life and present a technical challenge to the surgeon. Although several operative approaches have been described, results from a number of case series are variable and associated with significant rates of failure. As a result, there remains a lack of consensus in the literature with regard to the management of this troublesome problem. The purpose of this… 
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References

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TLDR
The results of surgery for ileoanal pouch–vaginal fistula have been disappointing, and a transvaginal approach was developed to achieve direct access to the internal opening, enabling closure without damage to the anal sphincter.
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TLDR
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TLDR
Pouch-vaginal fistula occurs in 6.3 (range, 3.3–15.8) percent of female patients with an ileal pouch–anal anastomosis and is the cause of considerable morbidity.
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TLDR
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TLDR
The pouch-vaginal fistula–free survival improved with repeated local or abdominal repairs for patients with ulcerative colitis, and repair in those patients with Crohn’s disease uniformly failed within five years from primary repair.
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TLDR
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TLDR
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TLDR
Pouch-vaginal fistulas are a difficult problem in females following restorative proctocolectomy, but local repair can be successful with good functional outcomes and a delayed diagnosis of Crohn’s disease results in worse treatment outcome and higher pouch failure rates.
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