BACKGROUND: Posterior fourchette fissures can recur and become chronic despite multiple medical and surgical treatments. We report the case of a recurrent posterior fourchette fissure that resolved after subdermal injection with adipose-derived regenerative cells.
CASE: A 44-year-old primiparous patient experienced severe dyspareunia for 10 years as a result of a recurrent posterior fourchette fissure that began after a vaginal delivery with episiotomy. She was treated unsuccessfully with topical antibiotics, estrogen, and steroids and ultimately with a perineoplasty at the age of 42 years. Adipose-derived regenerative cells were extracted enzymatically from her adipose tissue and injected subdermally and submucosally beneath the fissure and surrounding area. The fissure completely resolved within 3 months after treatment and has not recurred after more than 1 year of follow-up.
CONCLUSION: Subdermal injection of autologous adipose-derived regenerative cells may be a treatment option for treatment of recurrent fourchette fissures that do not respond to standard medical and surgical therapies.
A recurrent posterior fourchette fissure that did not respond to standard treatment for more than 10 years resolved after injection with autologous adipose-derived regenerative cells.
BelPrime Clinic and Medi Group, Belgrade, Serbia.
Corresponding author: Katarina Andjelkov, MD, PhD, BelPrime Clinic, Ohridska 16, Belgrade 11000, Serbia; email: firstname.lastname@example.org.
Financial Disclosure The authors did not report any potential conflicts of interest.
Each author has indicated that he or she has met the journal’s requirements for authorship.