Abstract
Occult sphincter injuries are quite common in normal vaginal delivery. These injuries may be symptomatic, especially in older patients. Rectal continence and function are disturbed when the complex rectovaginal fistula develops. Because of high recurrence rate in the treatment of complex rectovaginal fistula, a vascularized tissue transfer is required, especially in postmenopausal women. The authors report a case of complex rectovaginal fistula together with sphincter incontinence treated by gracilis musculocutaneous flap at the same time.
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