Imaging and surgical management of anorectal vaginal fistulas

Wendaline M. Vanburen, Amy Lightner, Sarasa T. Kim, Shannon P. Sheedy, Madeline C. Woolever, Christine O. Menias, Joel Garland Fletcher

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Anorectal vaginal fistulas (ARVFs) can result in substantial morbidity and potentially embarrassing symptoms in adult women of all ages. Despite having what may be obvious clinical manifestations, the fistulas themselves can be difficult to identify with imaging. MRI is the modality of choice for the diagnosis and characterization of ARVFs. A dedicated protocol involving the use of vaginal gel and optimized imaging planes with respect to the vagina, as well as an understanding of the MRI pelvic floor anatomy, is crucial for reporting surgically relevant details. Ancillary findings such as post-surgical changes, inflammation, abscess, sphincter destruction, and neoplasm are well evaluated. Vaginography, contrast enema, endoscopic US, and CT can be highly useful complementary diagnostic examinations. The entities that result in ARVFs may be obstetric, inflammatory (eg, Crohn disease and diverticulitis), neoplastic, iat-rogenic, and/or radiation induced. Surgical management is heavily dependent on the cause and complexity of the fistulizing disease, which are related to the location of the fistula in the vagina, the type and extent of fistula branching, the number of fistulas, sphincter tears, inflammation, and abscess.

Original languageEnglish (US)
Pages (from-to)1385-1401
Number of pages17
JournalRadiographics
Volume38
Issue number5
DOIs
StatePublished - Sep 1 2018

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Vaginal Fistula
Fistula
Vagina
Abscess
Foams and Jellies Vaginal Creams
Inflammation
Diverticulitis
Pelvic Floor
Enema
Tears
Crohn Disease
Obstetrics
Anatomy
Radiation
Morbidity
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Vanburen, W. M., Lightner, A., Kim, S. T., Sheedy, S. P., Woolever, M. C., Menias, C. O., & Fletcher, J. G. (2018). Imaging and surgical management of anorectal vaginal fistulas. Radiographics, 38(5), 1385-1401. https://doi.org/10.1148/rg.2018170167

Imaging and surgical management of anorectal vaginal fistulas. / Vanburen, Wendaline M.; Lightner, Amy; Kim, Sarasa T.; Sheedy, Shannon P.; Woolever, Madeline C.; Menias, Christine O.; Fletcher, Joel Garland.

In: Radiographics, Vol. 38, No. 5, 01.09.2018, p. 1385-1401.

Research output: Contribution to journalArticle

Vanburen, WM, Lightner, A, Kim, ST, Sheedy, SP, Woolever, MC, Menias, CO & Fletcher, JG 2018, 'Imaging and surgical management of anorectal vaginal fistulas', Radiographics, vol. 38, no. 5, pp. 1385-1401. https://doi.org/10.1148/rg.2018170167
Vanburen WM, Lightner A, Kim ST, Sheedy SP, Woolever MC, Menias CO et al. Imaging and surgical management of anorectal vaginal fistulas. Radiographics. 2018 Sep 1;38(5):1385-1401. https://doi.org/10.1148/rg.2018170167
Vanburen, Wendaline M. ; Lightner, Amy ; Kim, Sarasa T. ; Sheedy, Shannon P. ; Woolever, Madeline C. ; Menias, Christine O. ; Fletcher, Joel Garland. / Imaging and surgical management of anorectal vaginal fistulas. In: Radiographics. 2018 ; Vol. 38, No. 5. pp. 1385-1401.
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