{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T15:44:47Z","timestamp":1758123887560},"reference-count":0,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,4,20]],"date-time":"2014-04-20T00:00:00Z","timestamp":1397952000000},"content-version":"vor","delay-in-days":4767,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2001,4,1]],"date-time":"2001-04-01T00:00:00Z","timestamp":986083200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2001,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Creation of a neovagina to treat vaginal atresia or aplasia in Mayer\u2010Rokitansky\u2010Kuester\u2010Hauser syndrome must always be followed by long\u2010term application of dilators to avoid shrinkage. However, rectoneovaginal fistulas are caused by chronic alteration and consecutive necrosis of the posterior neovaginal wall. We evaluated retrospectively the postoperative outcome of rectal wall and neovaginal reconstruction using a standardized surgical technique in an exclusive collection of women. Eight women with a mean age of 28 years (range 22\u201331 years) were treated for rectoneovaginal fistulas in our clinic. Preoperatively, proctoscopy, sphincter manometry, endoluminal rectal ultrasonography, and colonoscopy were performed; and regular postoperative follow\u2010up by digital examination and rectoscopy were obligate. The standard surgical procedure via a perineal approach included fistulectomy and closure of the mucosa and rectal wall followed by a levatorplasty. All but one woman had a temporary colostomy. After 2 weeks the patients were allowed to wear vaginal dilators of a smaller size. Within the mean follow\u2010up period of 20\u00a0months, reintervention was necessary twice because of late fistula relapse detected by proctoscopy, barium enema, and subjective symptoms. Morbidity was 25% (<jats:italic>n<\/jats:italic>= 2) due to secondary superficial wound healing or urinary tract infection. The average time of the hospital stay was 13\u00a0days (10\u201314\u00a0days). One patient complained of vaginal shrinkage and underwent local estrogen therapy with a good functional result 3\u00a0months later. Proper fistulectomy and surgical reconstruction with interpositioning of well perfused muscle layers achieved good functional outcome with an acceptable number of minor morbidities. Local estrogen treatment is helpful for avoiding scarification and decreasing the neovaginal size.<\/jats:p>","DOI":"10.1007\/s002680020151","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T05:57:49Z","timestamp":1030255069000},"page":"438-440","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcome of Surgical Intervention for Rectoneovaginal Fistulas in Mayer\u2010Rokitansky\u2010Kuester\u2010Hauser Syndrome"],"prefix":"10.1002","volume":"25","author":[{"given":"Marc","family":"Schult","sequence":"first","affiliation":[{"name":"Department of Surgery University of Muenster 48129 Muenster Germany<!--<country1>DE<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heiner H.","family":"Wolters","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Muenster 48129 Muenster Germany<!--<country1>DE<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rainer J.","family":"Lell\u00e9","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Muenster 48129 Muenster Germany<!--<country1>DE<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00fcnther","family":"Winde","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Muenster 48129 Muenster Germany<!--<country1>DE<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Senninger","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Muenster 48129 Muenster Germany<!--<country1>DE<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,4,20]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s002680020151.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s002680020151\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s002680020151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T19:42:36Z","timestamp":1703706156000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s002680020151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,4]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2001,4]]}},"alternative-id":["10.1007\/s002680020151"],"URL":"https:\/\/doi.org\/10.1007\/s002680020151","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,4]]}}}