Rectovaginal fistula and rectal injury

Rectal injury and its possible unfortunate sequela, rectovaginal fistula, are rare occurrences and/or complications of obstetric and gynecologic disease or procedures. It can cause considerable distress and social disablement to the patient and challenge the gynecologic surgeon. At the Parkland Memorial Hospital, several techniques have been used and/or described: the Noble-Mengert-Fish anterior rectal wall advancement, the Martius bulbocavernosus graft, and the omental pull-down procedure.