Rectovaginal fistulae in Crohn’s disease: a management paradox

Abstract

The results of this study suggest that in the absence of significant symptoms, conservative management provides a good chance of fistula healing without need for proctectomy. However, if symptoms dictate the need for intervention, local repair provides a similar chance of success with a lower ultimate need for proctectomy than laying open or seton. Despite these broad generalities, this study highlights the difficulties we have in advising patients with proctovaginal fistulae in CD.