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International Urogynecology Journal

, Volume 27, Issue 3, pp 495–497 | Cite as

Repair of a traumatic cloaca after obstetric anal sphincter injury

  • Federico SpelziniEmail author
  • Matteo Frigerio
  • Stefano Manodoro
  • Debora Verri
  • Elena Nicoli
  • Rodolfo Milani
IUJ Video

Abstract

Introduction and hypothesis

Unsuccessful primary repair of fourth-degree obstetric trauma can lead to permanent communication between the rectum and the vagina, which, in association with full-thickness anal sphincter defects, is characterized by complete fecal incontinence and severe impairment of quality of life. The aim of this video is to serve as a tutorial for repair.

Methods

A 27-year-old woman who developed a full-thickness recto-vaginal defect extended from the perineum to the upper third of the vagina has been managed through layered surgical repair without flaps.

Results

Anatomy and fecal continence have been completely restored by a follow-up of 24 months.

Conclusion

The procedure described in this video has been shown to be effective and safe.

Keywords

Obstetric anal sphincter injury Traumatic cloaca Surgical repair 

Notes

Compliance with ethical standards

Consent

Consent was obtained from the patient for publication of this video article and any accompanying images.

Conflict of interest

None.

Supplementary material

ESM 1

(MP4 93670 kb)

References

  1. 1.
    RCOG (2007) Green-top guideline no. 29Google Scholar
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    Kaiser AM (2008) Cloaca-like deformity with faecal incontinence after severe obstetric injury—technique and functional outcome of ano-vaginal and perineal reconstruction with X-flaps and sphincteroplasty. Color Dis 10(8):827–832. doi: 10.1111/j.1463-1318.2007.01440.x CrossRefGoogle Scholar
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    Hollingshead JR, Warusavitarne J, Vaizey CJ, Northover JM (2009) Outcomes following repair of traumatic cloacal deformities. Br J Surg 96(9):1082–1085CrossRefPubMedGoogle Scholar
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    Spanos CP, Mikos T, Kastanias E, Georgantis G (2012) Surgical repair of traumatic cloaca. Arch Gynecol Obstet 286(3):815–818CrossRefPubMedGoogle Scholar
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    Valente MA, Khanduja KS (2012) Layered surgical repair of traumatic cloacal deformities: technical details and functional outcomes. Tech Coloproctol 16(2):153–156CrossRefPubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2015

Authors and Affiliations

  • Federico Spelzini
    • 1
    Email author
  • Matteo Frigerio
    • 1
  • Stefano Manodoro
    • 1
  • Debora Verri
    • 1
  • Elena Nicoli
    • 1
  • Rodolfo Milani
    • 1
  1. 1.Università Milano Bicocca, Azienda Ospedaliera San GerardoMonzaItaly

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