Separating the Rectum from the Vagina During Posterior Sagittal Anorectovagino-Urethroplasty / PSARVUP
Rectum Vagina Separation
Urethrovaginal Detail
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Colorectal Center surgeons Cincinnati Children's Hospital Medical Center provide information about separating the rectum from the vagina in Posterior Sagittal Anorectovagino-Urethroplasty / PSARVUP.
Separation of the rectum from the vagina must be done following the same principles described for other types of defects. A series of 6-0 silk stitches are placed, taking the rectal mucosa immediately above the vaginal fistula.
These stitches serve to exert uniform traction on the rectal wall while performing a submucosal dissection in that part of the common wall between rectum and vagina where there is no plane of separation.
About two centimeters above the vaginal orifice rectal and vaginal wall separate and become independent; thus, a full-thickness separation is achieved.
Gaining enough length for the rectum to achieve a nontense anastomosis between the rectum and the perineal skin is carried out in the same way as previously described for other defects.
Sometimes, the rectum is located too high in the pelvis, not visible and not reachable through the posterior sagittal incision. This situation represents one of the indications to perform a laparotomy.
For more information or to request an appointment, please contact the Colorectal Center at Cincinnati Children's.
