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Posterior Fourchette Fissure Resolution After Injection of Autologous Adipose-Derived Regenerative Cells

Andjelkov, Katarina MD, PhD; Maricic, Zoran MD

doi: 10.1097/AOG.0000000000001906
Contents: Case Report

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:

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.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.