Question
The patient is a female, about two and a half months old. In May, she underwent an anal correction and perineal fistula repair surgery at Qilu Hospital. After 40 days, she discovered that there was once again faecal leakage from the original leaking site on the upper lateral side of the perineum. Upon waking up, she has some difficulty urinating, needing to exert force (as the catheter was removed postoperatively).
Answer
Perineal fistulas are complex in nature, with various types, high rates of postoperative infection and recurrence, making repeat surgeries particularly challenging. Achieving a successful outcome requires careful selection of the surgical technique. For patients with congenital anal anomalies and rectovaginal fistulas, it is important to pay attention to: 1) the surgical approach and technique; 2) whether the distal rectum is sufficiently mobilized; 3) avoiding severe infection; 4) fully relaxing the distal rectal mucosa to ensure there is no tension at the suture site.