Table 1 Demographics, clinical characteristics, and outcome after vaginal laser therapy in patients with rectovaginal fistulas
Variable | Age (years) | Race | Etiology | Duration of the fistula (months) | Baseline clinical manifestations | Baseline treatment | Baseline Sexual activity yes/no (FSQ score) | Sexual activity after laser therapy Yes/no (FSQ score) | Outcome | Pelvic MRI after laser therapy | Site of the fistulaa/diameter before and after treatment |
|---|---|---|---|---|---|---|---|---|---|---|---|
Patient 1 | 50 | No white | Crohn’s disease | 24 | Vaginal burning, dyspareunia, foul-smelling discharge, significant vaginal tenderness to vaginal touch | Infliximab + prednisone 25 mg/day | Yes (40) | Yes (62) | Asymptomatic | Radiological improvement | Anovaginal 4 mm–2 mm |
Patient 2 | 40 | White | Pelvic surgery due to pelvic endometriosis | 12 | Foul-smelling minimal vaginal discharge, tenderness to vaginal touch, ostomized | None | No | Yes | Asymptomatic Ostomy reversal | Radiological remission | Rectovaginal 7,8 mm–0 |
Patient 3 | 29 | No white | Pelvic surgery due to pelvic endometriosis | 6 months | Foul-smelling minimal vaginal discharge, tenderness to vaginal touch, ostomized | None | No | Yes | Asymp-tomatic, ostomy reversal | Radiological remission | Rectovaginal 3 mm–0 |
Patient 4 | 38 | No white | Vulvovaginal surgery due to bartholin | 21 | Vaginal burning, passage of gas and feces from the vagina, foul-smelling significant vaginal discharge tenderness to vaginal touch | Patient had been submitted to two previous fistulectomies | No | Yes | Occasional foul-smelling minimal vaginal discharge | Radiological improvement | Anovaginal 7.5 mm–2 mm |
Patient 5 | 58 | No white | Crohn’s disease | 120 | Vaginal burning, passage of gas and feces from the vagina, foul-smelling significant vaginal discharge tenderness to vaginal touch | Infliximab and azathioprine | No | Yes | Occasional foul-smelling minimal vaginal discharge | Radiological improvement | Anovaginal 3 mm – 1,7 mm |
Patient 6 | 32 | White | Unknown | 24 | Vaginal burning, dyspareunia discharge, foul-smelling significant vaginal, tenderness to vaginal touch | Patient had been submitted to three earlier fistulectomies | Yes (34) | Yes (76) | Asymptomatic | Radiological improvement | Rectovaginal 4 mm–0 |
Patient 7 | 36 | White | Crohn’s disease | 48 | Vaginal burning dyspareunia passage of gas and feces from the vagina elimination of foul-smelling fluid vaginal touch was painful | Infliximab and azathioprine | Yes (20) | Yes (78) | Asymptomatic | Radiological remission | Anovaginal 4 mm–2 mm |
Patient 8 | 31 | White | Vaginal delivery with episiotomy | 12 | Vaginal burning dyspareunia passage of gas from the vagina elimination of foul-smelling fluid vaginal touch was painful | Previous fistulectomy | Yes (18) | Yes (90) | Passage of gas from the vagina elimination of foul-smelling fluid | Radiological improvement | Anovaginal 2.5 mm–2 mm |
Patient 9 | 31 | White | Vulvo-vaginal surgery due to bartholin | 24 | Dyspareunia passage of gas and feces from the vagina elimina-tion of foul-smelling fluid | Previous fistulectomy | Yes (74) | Yes (78) | Passage of gas from the vagina | Radiological remission | Anovaginal 3 mm–1.5 mm |
Patient 10 | 47 | White | Crohn’s disease | 36 | Elimina-tion of foul-smelling fluid Vaginal burning dyspareu-nia | Infliximab | Yes (32) | Yes (56) | Asympto-matic | Radiological remission | Anovaginal 3 mm–0 |
Patient 11 | 51 | White | Unknown | 48 | Elimina-tion of foul-smelling fluid vaginal, touch was painful, dyspareu-nia passage of gas from the vagina | Antibiotic | Yes (30) | Yes (76) | Asympto-matic | Radiological remission | Anovaginal 3 mm–2 mm |
Patient 12 | 69 | White | Histerec tomy + annexec- tomy bilateral | 9 | Elimina-tion of foul- smelling fluid, ostomized | None | No | No | Asympto-matic | Radiological remission | Anovaginal 3.5 mm–0 |
Patient 13 | 68 | No white | Rectosig- moidec- tomy due to rectal adeno-carcino-ma | 8 | Eliminati-on of foul- smelling fluid, ostomized | None | No | No | Asympto-matic | Radiological improvement | Anovaginal 4.4 mm–2.2 mm |
Patient 14 | 39 | No White | Crohn’s disease | 12 | Passage of gas from the vagina, elimina-tion of foul-smelling fluid | Infliximab and azathioprine | Yes (72) | Yes (72) | Passage of gas from the vagina | Radiological improve-ment | Anovaginal 3.3 mm–2.6 mm |
Patient 15 | 39 | White | Crohn’s disease | 48 | Elimina- tion of foul- smelling fluid vagina, touch painful, passage of gas from the vagina | Earlier fistulectomy, infliximab and azathioprine | No | Yes | Asympto-matic | Radiological improvement | Rectovaginal 3.7 mm–2.7 mm |