Buccal Mucosal Grafts: Novel Treatment for the Repair of Rectovaginal Fistulas
A Study Protocol (Preprint)
BACKGROUND Rectovaginal fistulas (RVFs) are abnormal communications between the rectum/anus and the vagina. They are most frequently a result of obstetric injury and have deleterious impacts on patients’ quality of life. Despite several treatment modalities, RVFs remain difficult problems to manage, and many patients fail multiple attempts at surgical repair. Buccal mucosal grafts (BMGs) may be a solution to this problem. A BMG is oral mucosal tissue harvested from the inner cheek. There are two case reports that describe the successful use of BMGs in the repair of RVFs. OBJECTIVE Our objective is to validate these findings with a prospective case series, while also addressing key issues of indication, technical details, procedure safety, and short-term outcomes. METHODS Our objective is to validate these findings with a prospective case series, while also addressing key issues of indication, technical details, procedure safety, and short-term outcomes. RESULTS Two previous case reports have described the successful use of BMGs in the repair of RVFs. We have received ethics approval to attempt to validate these findings through a prospective case series. CONCLUSIONS Rectovaginal fistulas cause significant patient morbidity and are difficult problems to manage. Bolstered by the successful use of BMGs in urologic surgery and the previously published case reports demonstrating success in RVFs, we believe that BMGs may be a solution to RVFs.