Challenges in imperforate anus: II--Large rectovaginal defects: colonic vaginoanoplasty.

There are several infants and young children with a large recto vaginal fistula or common recto vaginal opening. This could arise either as a result of previous surgery, or entirely congenitally. Surgical correction in these difficult patients has been satisfactorily achieved in 11 patients using a modification of the Soave technique in which the upper rectum and colon are brought through a rectal sleeve and sutured to the perineum. The pliability of the vagina, and control of bowel movements and the cosmetic appearance following this procedure are good. The procedure is not very demanding technically.