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Recordings

Concurrent Session 03: UTIs and Microbiome

J-Pouch Vaginal Fistula Repair with Endorectal Advancement and Martius Flaps

Thursday, October 24, 2024
12:02 PM – 12:12 PM EDT
Location: Independence Ballroom E-H (Meeting Level 4)
Live Streamed
Objectives: This video reviews J-pouch vaginal fistulae and displays an effective and successful interdisciplinary approach to the repair, using endorectal advancement and Martius flaps.

Methods: We present a 54-year-old multiparous female with a history of Crohn’s disease, who underwent total abdominal proctocolectomy with an ileal pouch-anal anastomosis (IPAA), complicated by a pouch-vaginal fistula (PVF). We examine the significance of IPAAs and highlight important pre-operative considerations. We demonstrate a J-Pouch-vaginal fistula repair with endorectal advancement, done by colorectal, and Martius flaps. We review postoperative complications and clinical outcomes.

Clinical Relevance: Pouch-vaginal fistulae pose a challenging clinical scenario with significant impacts on patient quality of life. The ideal approach to managing these fistulae is unclear, given significant morbidity associated with repair. A perineal approach is less morbid than other potential interventions, such as repeat IPAA. Bowel diversion is important for healing. Combined anal and vaginal approach to pouch-vaginal fistulae are an excellent option for intervention on these difficult cases.
Disclosure(s):
Elizabeth Hoang, MD: No financial relationships to disclose
Joyce H. Pang, MD: No financial relationships to disclose
Amarilis Camacho-Quinones, MD: No financial relationships to disclose
Lara McKean Baste, MD: No financial relationships to disclose
Sarah ES Jeney, MD: No financial relationships to disclose

    Video Presenter(s)

  • Elizabeth Hoang, MD

    Fellow
    University of New Mexico, Dept. of Urogynecology
    Albuquerque, New Mexico, United States

    Disclosure(s): No financial relationships to disclose

    • Co-Author(s)

  • JP

    Joyce H. Pang, MD

    Resident Physician
    University of New Mexico School of Medicine
    Albuquerque, New Mexico, United States

    Disclosure(s): No financial relationships to disclose

  • AC

    Amarilis Camacho-Quinones, MD

    Resident
    UNM Obstetrics and Gynecology Department
    Albuquerque, New Mexico, United States

    Disclosure(s): No financial relationships to disclose

  • LM

    Lara McKean Baste, MD

    Assistant Professor of Surgery
    University of New Mexico
    Albuquerque, New Mexico, United States

    Disclosure(s): No financial relationships to disclose

  • SJ

    Sarah ES Jeney, MD (she/her/hers)

    Assistant Professor
    University of New Mexico, Department of Obstetrics and Gynecology
    Albuquerque, New Mexico, United States

    Disclosure(s): No financial relationships to disclose