The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Osnat Zmora - One of the best experts on this subject based on the ideXlab platform.
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Recto-vaginal/urethral fistula: repair with Gracilis Muscle transposition.
Acta Chirurgica Iugoslavica, 2020Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, G GoldmanAbstract:This study was designed to assess the efficacy of Gracilis Muscle transposition in repairing rectovaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. Results: Six females and four males underwent Gracilis Muscle transposition from 1999 to 2006. Gracilis Muscle transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.
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Gracilis Muscle transposition for fistulas between the rectum and urethra or vagina
Diseases of The Colon & Rectum, 2006Co-Authors: Osnat Zmora, Hagit Tulchinsky, G Goldman, Joseph M Klausner, Micha RabauAbstract:PURPOSE: This study was designed to assess the efficacy of Gracilis Muscle transposition in repairing rectovaginal and rectourethral fistulas. METHODS: Data were retrieved from a retrospective chart review of patients who underwent Gracilis Muscle transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. RESULTS: Six females and three males, aged 30 to 64 years, underwent Gracilis Muscle transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1-66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. CONCLUSIONS: Gracilis Muscle transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
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recto vaginal urethral fistula repair with Gracilis Muscle transposition
Acta Chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, G GoldmanAbstract:This study was designed to assess the efficacy of Gracilis Muscle transposition in repairing rectovaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. Results: Six females and four males underwent Gracilis Muscle transposition from 1999 to 2006. Gracilis Muscle transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.
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Gracilis Muscle transposition for iatrogenic rectourethral fistula
Annals of Surgery, 2003Co-Authors: Osnat Zmora, Fabio M Potenti, Steven D Wexner, Alon J Pikarsky, Jonathan Efron, Juan J Nogueras, Victor E Pricolo, Eric G WeissAbstract:Rectourethral fistula poses a difficult surgical challenge. Fistulas between the lower rectum and the urethra may be congenital, with the constellation of pelvic floor malformations, or acquired, due to inflammation, infection, neoplasia, or trauma. Iatrogenic rectourethral fistulas can follow the treatment of prostatic cancer. Although uncommon, these fistulas may occur following radical prostatectomy, 1 radiotherapy, 2 cryosurgery, 3 or seed implantation for the treatment of prostate carcinoma. Although symptoms such as pneumaturia, fecaluria, and the passage of urine through the rectum are often alleviated by fecal and urinary diversion, these fistulas seldom spontaneously heal. 4 Even when diverted, patients may suffer from urinary tract infections, resistant to medical therapy. 5 Thus, most of these patients will eventually require surgical treatment. Numerous surgical procedures have been described for the treatment of rectourethral fistula, 1,4,6–9 none of which has gained wide acceptance as the procedure of choice. The diversity in treatment methods, combined with the limited reported success rates, attest to the complexity of this difficult condition. After gaining significant experience with the harvest and transposition of the Gracilis Muscle for fecal incontinence, 10,11 we began to favor its use for the treatment of unhealed perineal wounds 12 and rectourethral fistulas. The aim of this study was to review our experience with Gracilis Muscle transposition for the surgical treatment of iatrogenic rectourethral fistula resulting from treatment for prostatic carcinoma.
Micha Rabau - One of the best experts on this subject based on the ideXlab platform.
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Recto-vaginal/urethral fistula: repair with Gracilis Muscle transposition.
Acta Chirurgica Iugoslavica, 2020Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, G GoldmanAbstract:This study was designed to assess the efficacy of Gracilis Muscle transposition in repairing rectovaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. Results: Six females and four males underwent Gracilis Muscle transposition from 1999 to 2006. Gracilis Muscle transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.
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Gracilis Muscle transposition for fistulas between the rectum and urethra or vagina
Diseases of The Colon & Rectum, 2006Co-Authors: Osnat Zmora, Hagit Tulchinsky, G Goldman, Joseph M Klausner, Micha RabauAbstract:PURPOSE: This study was designed to assess the efficacy of Gracilis Muscle transposition in repairing rectovaginal and rectourethral fistulas. METHODS: Data were retrieved from a retrospective chart review of patients who underwent Gracilis Muscle transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. RESULTS: Six females and three males, aged 30 to 64 years, underwent Gracilis Muscle transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1-66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. CONCLUSIONS: Gracilis Muscle transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
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recto vaginal urethral fistula repair with Gracilis Muscle transposition
Acta Chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, G GoldmanAbstract:This study was designed to assess the efficacy of Gracilis Muscle transposition in repairing rectovaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. Results: Six females and four males underwent Gracilis Muscle transposition from 1999 to 2006. Gracilis Muscle transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.
Eric G Weiss - One of the best experts on this subject based on the ideXlab platform.
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Gracilis Muscle interposition for the treatment of rectourethral rectovaginal and pouch vaginal fistulas results in 53 patients
Annals of Surgery, 2008Co-Authors: Steven D Wexner, Juan J Nogueras, Eric G Weiss, Dan Ruiz, Jill Genua, Oded ZmoraAbstract:Background: The aim of this study was to review our experience with Gracilis Muscle interposition for complex perineal fistulas. Material and Methods: A retrospective review of all patients who underwent repair of perineal fistula using the Gracilis Muscle between 1995 and 2007 was undertaken. Patients were divided into 2 groups according to the fistula type by gender: females (rectovaginal and pouch-vaginal) and males (rectourethral). Results: Gracilis interposition was performed in 53 patients. Seventeen women underwent 19 Gracilis interpositions for 15 rectovaginal and 2 pouch-vaginal fistulas; 76% had a mean of (1-4) (mean of 2) prior failed attempt at repair. Eight patients experienced at least one postoperative complication. Two women required a second Gracilis interposition. Thirty-three percent of the Crohn's disease-associated fistulas successfully healed; 75% without Crohn's successfully healed. Thirty-six males underwent Gracilis interposition for rectourethral fistulas, mainly due to prostate cancer treatment; 13 (36%) had a mean of 1.5 (range 1-3) failed prior repairs. Seventeen patients experienced postoperative complications. The initial success rate in men with rectourethral fistulas was 78%. After successful second procedures in 8 patients, the overall clinical healing rate was 97%. Conclusion: The Gracilis Muscle transposition is a safe and effective method of treating complex perianal fistulas.
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Gracilis Muscle transposition for iatrogenic rectourethral fistula
Annals of Surgery, 2003Co-Authors: Osnat Zmora, Fabio M Potenti, Steven D Wexner, Alon J Pikarsky, Jonathan Efron, Juan J Nogueras, Victor E Pricolo, Eric G WeissAbstract:Rectourethral fistula poses a difficult surgical challenge. Fistulas between the lower rectum and the urethra may be congenital, with the constellation of pelvic floor malformations, or acquired, due to inflammation, infection, neoplasia, or trauma. Iatrogenic rectourethral fistulas can follow the treatment of prostatic cancer. Although uncommon, these fistulas may occur following radical prostatectomy, 1 radiotherapy, 2 cryosurgery, 3 or seed implantation for the treatment of prostate carcinoma. Although symptoms such as pneumaturia, fecaluria, and the passage of urine through the rectum are often alleviated by fecal and urinary diversion, these fistulas seldom spontaneously heal. 4 Even when diverted, patients may suffer from urinary tract infections, resistant to medical therapy. 5 Thus, most of these patients will eventually require surgical treatment. Numerous surgical procedures have been described for the treatment of rectourethral fistula, 1,4,6–9 none of which has gained wide acceptance as the procedure of choice. The diversity in treatment methods, combined with the limited reported success rates, attest to the complexity of this difficult condition. After gaining significant experience with the harvest and transposition of the Gracilis Muscle for fecal incontinence, 10,11 we began to favor its use for the treatment of unhealed perineal wounds 12 and rectourethral fistulas. The aim of this study was to review our experience with Gracilis Muscle transposition for the surgical treatment of iatrogenic rectourethral fistula resulting from treatment for prostatic carcinoma.
Steven D Wexner - One of the best experts on this subject based on the ideXlab platform.
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Gracilis Muscle interposition for the treatment of rectourethral rectovaginal and pouch vaginal fistulas results in 53 patients
Annals of Surgery, 2008Co-Authors: Steven D Wexner, Juan J Nogueras, Eric G Weiss, Dan Ruiz, Jill Genua, Oded ZmoraAbstract:Background: The aim of this study was to review our experience with Gracilis Muscle interposition for complex perineal fistulas. Material and Methods: A retrospective review of all patients who underwent repair of perineal fistula using the Gracilis Muscle between 1995 and 2007 was undertaken. Patients were divided into 2 groups according to the fistula type by gender: females (rectovaginal and pouch-vaginal) and males (rectourethral). Results: Gracilis interposition was performed in 53 patients. Seventeen women underwent 19 Gracilis interpositions for 15 rectovaginal and 2 pouch-vaginal fistulas; 76% had a mean of (1-4) (mean of 2) prior failed attempt at repair. Eight patients experienced at least one postoperative complication. Two women required a second Gracilis interposition. Thirty-three percent of the Crohn's disease-associated fistulas successfully healed; 75% without Crohn's successfully healed. Thirty-six males underwent Gracilis interposition for rectourethral fistulas, mainly due to prostate cancer treatment; 13 (36%) had a mean of 1.5 (range 1-3) failed prior repairs. Seventeen patients experienced postoperative complications. The initial success rate in men with rectourethral fistulas was 78%. After successful second procedures in 8 patients, the overall clinical healing rate was 97%. Conclusion: The Gracilis Muscle transposition is a safe and effective method of treating complex perianal fistulas.
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Gracilis Muscle transposition for iatrogenic rectourethral fistula
Annals of Surgery, 2003Co-Authors: Osnat Zmora, Fabio M Potenti, Steven D Wexner, Alon J Pikarsky, Jonathan Efron, Juan J Nogueras, Victor E Pricolo, Eric G WeissAbstract:Rectourethral fistula poses a difficult surgical challenge. Fistulas between the lower rectum and the urethra may be congenital, with the constellation of pelvic floor malformations, or acquired, due to inflammation, infection, neoplasia, or trauma. Iatrogenic rectourethral fistulas can follow the treatment of prostatic cancer. Although uncommon, these fistulas may occur following radical prostatectomy, 1 radiotherapy, 2 cryosurgery, 3 or seed implantation for the treatment of prostate carcinoma. Although symptoms such as pneumaturia, fecaluria, and the passage of urine through the rectum are often alleviated by fecal and urinary diversion, these fistulas seldom spontaneously heal. 4 Even when diverted, patients may suffer from urinary tract infections, resistant to medical therapy. 5 Thus, most of these patients will eventually require surgical treatment. Numerous surgical procedures have been described for the treatment of rectourethral fistula, 1,4,6–9 none of which has gained wide acceptance as the procedure of choice. The diversity in treatment methods, combined with the limited reported success rates, attest to the complexity of this difficult condition. After gaining significant experience with the harvest and transposition of the Gracilis Muscle for fecal incontinence, 10,11 we began to favor its use for the treatment of unhealed perineal wounds 12 and rectourethral fistulas. The aim of this study was to review our experience with Gracilis Muscle transposition for the surgical treatment of iatrogenic rectourethral fistula resulting from treatment for prostatic carcinoma.
G Goldman - One of the best experts on this subject based on the ideXlab platform.
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Recto-vaginal/urethral fistula: repair with Gracilis Muscle transposition.
Acta Chirurgica Iugoslavica, 2020Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, G GoldmanAbstract:This study was designed to assess the efficacy of Gracilis Muscle transposition in repairing rectovaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. Results: Six females and four males underwent Gracilis Muscle transposition from 1999 to 2006. Gracilis Muscle transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.
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Gracilis Muscle transposition for fistulas between the rectum and urethra or vagina
Diseases of The Colon & Rectum, 2006Co-Authors: Osnat Zmora, Hagit Tulchinsky, G Goldman, Joseph M Klausner, Micha RabauAbstract:PURPOSE: This study was designed to assess the efficacy of Gracilis Muscle transposition in repairing rectovaginal and rectourethral fistulas. METHODS: Data were retrieved from a retrospective chart review of patients who underwent Gracilis Muscle transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. RESULTS: Six females and three males, aged 30 to 64 years, underwent Gracilis Muscle transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1-66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. CONCLUSIONS: Gracilis Muscle transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
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recto vaginal urethral fistula repair with Gracilis Muscle transposition
Acta Chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, G GoldmanAbstract:This study was designed to assess the efficacy of Gracilis Muscle transposition in repairing rectovaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. Results: Six females and four males underwent Gracilis Muscle transposition from 1999 to 2006. Gracilis Muscle transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.
