RT02: Complex Postpartum Care: Managing Wound Breakdown, Fistulae & Fecal Incontinence

The management strategies of postpartum perineal wound breakdown, recto- and anovaginal fistulae, and fecal incontinence are complex and often nuanced. There is very little data guiding the management of these clinical scenarios, and most guidelines or recommendations that exist are based on case series and expert opinion. The format of this roundtable will be facilitator-led case presentations of obstetric anal sphincter injury wound breakdown, postpartum rectovaginal fistula and postpartum fecal incontinence. Each case will be followed by a group discussion of management strategies and a brief review of the available literature. The roundtable format fits this topic well given the lack of clearcut guidelines and will serve as a learning and information sharing opportunity for providers who encounter complex postpartum care after vaginal deliveries. The facilitators listed are board-certified Urogynecologists who also direct specialized postpartum pelvic floor healing clinics at their respective institutions. Thus, each of us is highly dedicated to and well versed in these patient scenarios. Additionally, the facilitators are from different institutions, which adds insight and discussion regarding varying institutional experiences.