St Mark’s protocol for standardised examination under anaesthesia for rectovaginal fistulae
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By
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Okocha, M.
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Rowe, A.
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Elgendy, K.
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Thomas, G.
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Tozer, P.
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Vaizey, C.
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March 6, 2026
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Objective:
To document the St Mark’s protocol for examination under anaesthesia (EUA) in suspected rectovaginal fistulae.
Key Findings:
- The five-stage protocol provides a structured approach to assess rectovaginal fistulae.
- Intraoperative endoanal ultrasonography enhances anatomical definition.
- The protocol is beneficial for patients with ambiguous imaging or persistent symptoms.
Interpretation:
The St Mark’s protocol enables comprehensive evaluation and documentation of rectovaginal fistulae, facilitating informed surgical decision-making.
Limitations:
- Dependence on local expertise for intraoperative endoanal ultrasonography.
- Potential variability in the availability of diagnostic modalities.
Conclusion:
This protocol offers a reproducible framework for diagnosing and managing rectovaginal fistulae, particularly in complex cases.
