Case Report: Minimally invasive surgical management of a complex high rectovaginal fistula caused by long-term retained and migrated intrauterine device - Scorecard - MDSpire
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Case Report: Minimally invasive surgical management of a complex high rectovaginal fistula caused by long-term retained and migrated intrauterine device
Clinical Scorecard: Surgical Case Study: Innovative Minimally Invasive Approach for Managing a Complex High Rectovaginal Fistula Resulting from a Long-Term Migrated Intrauterine Device
At a Glance
Category
Detail
Condition
Rectovaginal fistula (RVF) secondary to migrated intrauterine device (IUD)
Key Mechanisms
Migration of IUD leading to abnormal epithelialized tract between rectum and vagina
Target Population
Women with migrated IUD and associated RVF
Care Setting
Multidisciplinary surgical intervention
Key Highlights
Rare case of high-level RVF due to long-term retained migrated metallic IUD
Successful treatment via combined laparoscopic transabdominal-transvaginal approach
No postoperative complications or fistula recurrence observed during follow-up
Guideline-Based Recommendations
Diagnosis
Preoperative pelvic contrast-enhanced CT and colonoscopy for assessment
Management
Laparoscopic proctectomy and combined transabdominal-transvaginal fistula repair
Monitoring & Follow-up
Long-term follow-up after IUD insertion and surgical intervention
Risks
High postoperative recurrence rate and risk of adjacent organ injury
Patient & Prescribing Data
43-year-old female with complex RVF and migrated IUD
Minimally invasive surgical approach with multidisciplinary collaboration
Clinical Best Practices
Thorough preoperative evaluation and imaging studies
Multidisciplinary consultation for complex cases
Use of tension-free repair techniques in fistula management
