Rectoneovaginal fistulae (RnVFs) are abnormal connections between the rectum and a surgically created neovagina. Although very uncommon, they confer significant morbidity in patients and may require a multidisciplinary team approach to the repair. Risk factors for RnVF include rectal injury at the time of neovaginoplasty, malignancy in the neovagina, trauma (iatrogenic or otherwise), radiation, and neovaginal revision surgery.
The patient is a 64-year-old transgender woman with recurrent RnVF following penile skin inversion neovaginoplasty, which was complicated by an intraoperative rectal injury. After failing an initial attempt at repair, the fistula was successfully repaired with a buccal mucosa graft.
In some cases, RnVFs following vaginoplasty surgery for gender affirmation may be repaired successfully with a buccal mucosa graft.
We discuss a transgender woman with recurrent rectoneovaginal fistula successfully repaired using buccal mucosa graft.
From the *Department of Urology, Glickman Urologic and Kidney Institute,
†Department of Colorectal Surgery, Digestive Disease Institute, and
‡Center for Urogynecology & Pelvic Reconstructive Surgery; Obstetrics, Gynecology & Women’s Health Institute, Cleveland Clinic, Cleveland, OH.
Reprints: Molly Abbott Elmer-DeWitt, MD, Q-10, 9500 Euclid Ave, Cleveland, OH 44195. E-mail: firstname.lastname@example.org; email@example.com.
The authors have declared they have no conflicts of interest.