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Rectal Complications After Perineorrhaphy and Episiotomy

Arch Surg. 1966;93(4):634-637. doi:10.1001/archsurg.1966.01330040098018.
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IMMEDIATE recognition of rectovaginal and rectoperineal injuries incident to perineorrhaphies and closures of episiotomies and the observance of sound surgical principles in their repair have led to a material reduction in the number of complications from these sources. Nevertheless, complications still develop surprisingly often, creating problems for the surgeon as well as for the patient. During the past 20 years the authors have treated 145 patients for these conditions, 128 of whom had a rectoperineal or rectovaginal fistula, 11 of whom had incontinence associated with an old third degree laceration, and 6 of whom had postpartum rectal hemorrhage. The clinical aspects of these injuries and the methods which we have used in their repair are described.


Fistulas.  —Rectoperineal fistulas may lie either superficial or deep to the sphincter ani muscles, while rectovaginal fistulas are located deep to the perineal body. The secondary openings of both, if produced by perineorrhaphy


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