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Obstetrics and gynecology · Feb 2010
Case ReportsFistula-in-ano: an uncommon cause of chronic vulvar symptoms.
- Cherie LeFevre, Elisabeth A Erekson, Susan Hoffstetter, and Mary McLennan.
- Department of Obstetrics, Saint Louis University, St Louis, Missouri 63117, USA.
- Obstet Gynecol. 2010 Feb 1; 115 (2 Pt 2): 421-3.
BackgroundRectal and anal fistulae are frequently missed diagnoses. Symptoms of fistula-in-ano may mimic other chronic vulvar conditions.CasesThree patients presented with chronic symptoms including nonhealing ulcer, pruritus, dyspareunia, and discharge for 6-18 months. High clinical suspicion and rectal examination with concomitant perineal probing was useful in making a diagnosis. Once the diagnosis of fistula-in-ano was made, surgical correction was successful.ConclusionWhen evaluating persistent vulvar problems, the clinician's differential diagnoses should include less common causes. The goals of treatment for fistula-in-ano should be to eliminate the nidus of infection and to preserve the anal sphincter during the repair.
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