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Rectovaginal Fistula as a Complication to a Bartholin Gland Excision

Zoulek, Emily DO; Karp, Deborah R. MD; Davila, G. Willy MD

doi: 10.1097/AOG.0b013e3182235548
Case Reports
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BACKGROUND: Rectovaginal fistula is a rare complication of inflammatory bowel disease, obstetric trauma, pelvic surgery, radiation, and trauma. We present a rectovaginal fistula occurring after an excision of a Bartholin gland.

CASE: A healthy 43-year-old woman presented with flatus per vagina immediately after a Bartholin gland excision. She had a history of recurrent Bartholin abscess and had undergone multiple incision and drainage procedures of this cyst over the past 6 years. On rectovaginal examination, the patient was found to have a rectovaginal fistula and subsequently underwent successful transvaginal repair.

CONCLUSION: Rectovaginal fistula can occur after excision of a Bartholin gland. This case report illustrates a rare and serious complication to a commonly performed gynecologic procedure.

Rectovaginal fistula may result as a complication of a Bartholin gland excision.

From the Department of Obstetrics and Gynecology, Mercy Health Partners, Muskegon, Michigan; and Section of Urogynecology/Reconstructive Pelvic Surgery, Cleveland Clinic, Weston, Florida.

Corresponding author: G. Willy Davila, MD, 2950 Cleveland Clinic Boulevard, Weston, FL 33331; e-mail: davilag@ccf.org.

Financial Disclosure Dr. Davila has been a consultant to and received payment for lectures, including service on speakers' bureaus, from American Medical Systems, Astellas, and Novasys Medical. Money has been paid to Dr. Davila's institution for grants from American Medical Systems and CL Medical. The other authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists