[Vaginal flap for rectovaginal fistulae in Crohn's disease].

OBJECTIVES

To evaluate efficacy and functional results (sexual activity) of vaginal flap for rectovaginal fistula in Crohn's disease.

PATIENTS AND

METHODS

From May 2004 to March 2008, we proposed a vaginal flap in patients who had a rectovaginal fistula in Crohn's disease and for which rectal flap was technically impossible. Monitoring included a clinical examination at 1 month and every 3 months for 1 year, Perianal Disease Activity Index for sexual activity evaluation. Every year and in April 2009 the nursing team during a telephone interview filled a standardized questionnaire.

RESULTS

We treated 5 patients. At 6 months, 4 of 5 patients were healed. At 7 months, 1 patient presented a new flare up of CD with reopening of the fistula. The other 3 patients were still healed at a median follow-up of 30.66 months (15 to 59). One patient presented dyspareunia during 3 months.

DISCUSSION AND

CONCLUSION

Vaginal flap is an effective technique that entails neither prolonged dyspareunia nor fecal incontinence. Stoma is not systematic.