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Aimjirakul K, Seehanantawong T, Saraluck A. Vaginocutaneous fistula caused by recurrent labial abscess: A case report. Case Rep Womens Health 2025; 46:e00698. [PMID: 40134469 PMCID: PMC11931305 DOI: 10.1016/j.crwh.2025.e00698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2025] [Revised: 03/04/2025] [Accepted: 03/05/2025] [Indexed: 03/27/2025] Open
Abstract
Urogenital fistulas are characterized by communication tracts that connect two surfaces or distinct organ systems. A vaginocutaneous fistula is a rare type of urogenital fistula that is characterized by persistent perineal discharge. This case report describes a female patient who suffered from recurrent labial abscesses and a fistula that connected the lower vagina to the inner thigh. There were symptoms of persistent perineal discharge, and the patient had an offensive odor. The patient had a history of six recurrent right labial abscesses over a period of two years prior to the formation of two fistulous openings. The right medial aspect of the inner thigh, adjacent to the labia majora, was found to have a 0.7 cm opening, which was confirmed by magnetic resonance imaging. Intraoperatively, the fistulous tract was readily delineated using dye. Complete fistulectomy was performed. This report highlights an unusual presentation of a urogenital fistula, the diagnostic challenges, and the management strategies. It emphasizes the need for timely identification and intervention in such cases.
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Affiliation(s)
- Komkrit Aimjirakul
- Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rajataewe, Bangkok 10400, Thailand
| | - Teerapan Seehanantawong
- Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rajataewe, Bangkok 10400, Thailand
| | - Apisith Saraluck
- Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rajataewe, Bangkok 10400, Thailand
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Maternini M, Guttadauro A, Avella P, Buondonno A, Mascagni D, Milito G, Stuto A, Renzi A, Rennis M, Bottini C, Quarto G, Nudo R, Del Re L, Amato B, Gabrielli F. Collagen treatment of complex anorectal fistula: 3 years follow-up. Open Med (Wars) 2023; 18:20220553. [PMID: 37465352 PMCID: PMC10350888 DOI: 10.1515/med-2022-0553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 05/16/2022] [Accepted: 08/12/2022] [Indexed: 07/20/2023] Open
Abstract
Fistula in ano is a common anorectal disease in adults. Currently, surgery remains the definitive therapeutic approach, but in some cases, it can lead to serious complications as faecal or gas incontinence. Therefore, sphincter sparing treatments should be considered for complex fistulas. One of the sphincteric preserving treatment is the filling with a dermal extract commonly called "collagen glue" as Salvecoll-E® gel. This is a multicentric, prospective, observational study on the use of Salvecoll-E® gel in treatment of complex anal fistulas. We treated 70 patients from May 2016 to May 2017. In the first phase, we debrided the fistula tract using a loose seton kept for 4-6 weeks. In the second phase, the seton was removed and the fistula tract was filled with Salvecoll-E® gel. In this article, we report results at 36 months of follow-up. Fifty patients (71.4%) had completely healed fistula within 36 months of follow-up. Twenty-eight patients (28.2%) had recurrences. Among these failures, 65% were within 6 months. All low transphincteric fistulas healed. Recurrences occurred only in median and high transphincteric fistulas. No patient had a worsening of continence status measured with Cleveland Clinic Florida Incontinence Severity score. Salvecoll-E® gel is a recent finding among sphincter-sparing treatments. In this study, we demonstrate that it is a safe option in the treatment of complex fistulas. Final results are satisfactory and in line with the best results published in literature among mini-invasive treatments.
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Affiliation(s)
- Matteo Maternini
- General Surgery Department, Istituti clinici Zucchi of Monza, University of Milano-Bicocca, 20126, Milan, Italy
| | - Angelo Guttadauro
- General Surgery Department, Istituti clinici Zucchi of Monza, University of Milano-Bicocca, 20126, Milan, Italy
| | - Pasquale Avella
- Department of Medicine and Health Sciences “V. Tiberio,” University of Molise, Via Francesco De Sanctis 1, 86100, Campobasso, Italy
| | - Antonio Buondonno
- Department of Medicine and Health Sciences “V. Tiberio,” University of Molise, Via Francesco De Sanctis 1, 86100, Campobasso, Italy
| | - Domenico Mascagni
- General Surgery Department, Policlinico Umberto I, University La Sapienza of Rome, 00161, Rome, Italy
| | - Giovanni Milito
- General Surgery Department, University Hospital of Roma “Tor Vergata,”00133, Rome, Italy
| | - Angelo Stuto
- General Surgery Department, IRCCS Policlinico San Donato of Milano, 20097, Milan, Italy
| | - Adolfo Renzi
- General Surgery Department, Clinica Villa Delle Querce, 80136, Naples, Italy
| | - Maria Rennis
- General Surgery Department, Ospedale San Gerardo di Monza, University of Milano-Bicocca, 20900, Milan, Italy
| | - Corrado Bottini
- General Surgery Department, Hospital of Gallarate, 21013, Varese, Italy
| | - Gennaro Quarto
- Department of Clinical Medicine and Surgery, University of Naples “Federico II,”Via S. Pansini, 5, 80131Naples, Italy
| | - Raffaele Nudo
- General Surgery Department, Casa di Cura Fabia Mater, 00171, Rome, Italy
| | - Luca Del Re
- General Surgery Department, Ospedale Multimedica San Giuseppe of Milano, 20123, MilanItaly
| | - Bruno Amato
- Department of Public Health, University of Naples “Federico II,”Via S. Pansini, 5, 80131Naples, Italy
| | - Francesco Gabrielli
- General Surgery Department, Istituti clinici Zucchi of Monza, University of Milano-Bicocca, 20126, Milan, Italy
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Singh M, Varela CE, Whyte W, Horvath MA, Tan NCS, Ong CB, Liang P, Schermerhorn ML, Roche ET, Steele TWJ. Minimally invasive electroceutical catheter for endoluminal defect sealing. SCIENCE ADVANCES 2021; 7:eabf6855. [PMID: 33811080 PMCID: PMC11057783 DOI: 10.1126/sciadv.abf6855] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
Surgical repair of lumen defects is associated with periprocedural morbidity and mortality. Endovascular repair with tissue adhesives may reduce host tissue damage, but current bioadhesive designs do not support minimally invasive deployment. Voltage-activated tissue adhesives offer a new strategy for endoluminal repair. To facilitate the clinical translation of voltage-activated adhesives, an electroceutical patch (ePATCH) paired with a minimally invasive catheter with retractable electrodes (CATRE) is challenged against the repair of in vivo and ex vivo lumen defects. The ePATCH/CATRE platform demonstrates the sealing of lumen defects up to 2 millimeters in diameter on wet tissue substrates. Water-tight seals are flexible and resilient, withstanding over 20,000 physiological relevant stress/strain cycles. No disruption to electrical signals was observed when the ePATCH was electrically activated on the beating heart. The ePATCH/CATRE platform has diverse potential applications ranging from endovascular treatment of pseudo-aneurysms/fistulas to bioelectrodes toward electrophysiological mapping.
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Affiliation(s)
- Manisha Singh
- NTU-Northwestern Institute for Nanomedicine (NNIN), Interdisciplinary Graduate School (IGS), Nanyang Technological University (NTU), 50 Nanyang Drive, Singapore 637553, Singapore
- School of Materials Science and Engineering (MSE), Nanyang Technological University (NTU), Singapore 639798, Singapore
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Claudia E Varela
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Harvard-MIT Program in Health Sciences and Technology, Cambridge, MA 02139, USA
| | - William Whyte
- Harvard-MIT Program in Health Sciences and Technology, Cambridge, MA 02139, USA
| | - Markus A Horvath
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Harvard-MIT Program in Health Sciences and Technology, Cambridge, MA 02139, USA
| | - Nigel C S Tan
- School of Materials Science and Engineering (MSE), Nanyang Technological University (NTU), Singapore 639798, Singapore
| | - Chee Bing Ong
- Histopathology/Advanced Molecular Pathology Lab, Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology, and Research, 61 Biopolis Drive, Singapore 138673, Singapore
| | - Patric Liang
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA
| | - Marc L Schermerhorn
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA
| | - Ellen T Roche
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Terry W J Steele
- NTU-Northwestern Institute for Nanomedicine (NNIN), Interdisciplinary Graduate School (IGS), Nanyang Technological University (NTU), 50 Nanyang Drive, Singapore 637553, Singapore.
- School of Materials Science and Engineering (MSE), Nanyang Technological University (NTU), Singapore 639798, Singapore
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