Congenital H-type ano-vestibular fistula with normal anus

Abstract

H-type ano-vestibular fistula with a normal anus is a rare type of anorectal malformations in female children. Although most cases are considered to be congenital, some authors suggested that this was an acquired condition. There is a high incidence of associated anomalies reaching up to 20–60% of the cases. The most common anomalies are anal stenosis, ectopic anus, cardiac and urological malformations. Many surgical techniques have been developed since the first description of this condition by Bryndorf in 1960. However, there is no consensus regarding the optimal surgical procedure due to the low number of cases reported in the literature. After reviewing these surgical techniques and their outcome, we can conclude that the main principles for a good repair are good preoperative bowel preparation, complete excision of the fistulous tract, good closure of the intervening tissue between the rectum and vagina in layers, avoidance of apposing suture lines and good post-operative nursing to keep the wound clean and dry as much as possible.

Keywords

• H-type ano-vestibular fistula
• Recto-vestibular fistula
• Anorectal malformations