Page 247 - Manual of Equine Field Surgery

Rectovaginal Fistula Repair 243

mare's natural perinea! conformation or the result
•
. of altering the perinea! conformation during a

rectovaginal fistula repair, and may be addressed

with a urethroplasty procedure.9 Mares should be

monitored closely during subsequent foalings

because fibrous tissue may reduce the elasticity of

the birth canal and predispose the mare to addi-

tional birthing trauma. As the sutures are pro-
8

gressively placed in the caudal tissues, care must

be taken to avoid narrowing of the rectal lumen,

which will predispose the mare to tenesmus and

constipation.

REFERENCES

1. Adams S, Benker F, Brandenburg T: Direct rec-

tovestibular fistula repair in five mares, Proc Am

Assoc Equine Pract 42:156, 1996.
A
2. Schonfelder AM, Sobiraj A: A vaginal mucosal

:..
pedicle flap technique for repair of rectovaginal

fistula in mares, Vet Surg 33:517, 2004.

3. Aanes WA: Surgical management of foaling

injuries, Vet Clin N Am Equine Pract 4:417, 1988.

B 4. Beard W: Standing urogenital surgery, Vet Clin N

Am Equine Pract 7:669, 1991.

5. Huber MJ: Modified technique for single stage rec-
Figure 43-15 A, Closure of the fistula, B, Sagittal tovestibular fistula closure in three mares, Equine

cross section of suture placement for closure of the

fistula. Vet J 30:82, 1998.
6. Schofield WL: Surgical repair of rectovaginal lacer-

ations and fistulae in 20 mares, Irish Vet J 51:468,

1998.

7. Klug E,Almdida-Sampaio AJS, Aupperle H: Repair

COMPLICATIONS of the rectovaginal fistula in the mare a new sur-

gical approach, Pferdeheilkunde 17:600, 2001.

Suture debiscence and subsequent fistula devel- 8. Colbern GT, Aanes WA, Stashak TS: Surgical man-

opment are possible. These complications can be agement of perinea! lacerations and rectovestibular

minimized by precise dissection, adequate tissue fistulae in the mare: a retrospective study of 47
cases,] Am Vet Med Assoc 186:265, 1985.
purchases, and reduced tension on apposed 9. Belknap JI(, Nickels FA: A one-stage repair of third-

tissues. Fistula recurrence may result in failure to degree perineal lacerations and rectovestibular fis-

conceive due to endometritis, pneumovagina, or tulae in 17 mares, Vet Surg 21:378, 1992.

continued fecal contamination of the vaginal 10. HilbertJ: Surgical repair of recto-vaginal fistulae in

lumen. Urovagina may be a consequence of the mares, Aust Vet J 57:85, 1981.