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Obstetrics & Gynecology 1999;93:800-802
© 1999 by The American College of Obstetricians and Gynecologists
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GYNECOLOGY

FISTULA-IN-ANO AFTER EPISIOTOMY

Denise Howard, MD, MPH, John O. L. DeLancey, MD and Richard E. Burney, MD

From the Departments of Obstetrics and Gynecology, and Surgery, University of Michigan Health Systems, Ann Arbor, Michigan.

Address reprint requests to: John O. L. DeLancey, MD Department of Obstetrics and Gynecology University of Michigan Health Systems L4000 Women’s Hospital 1500 E. Medical Center Drive Ann Arbor, MI 48109-0276 E-mail: delancey{at}umich.edu

Background: In the past 2 years, we treated three women with fourth-degree lacerations or episiotomy infections presenting with persistent pain and drainage not responding to standard treatment.

Cases: These women were referred for evaluation 5 weeks, 3.5 months, and 2 years postpartum. After diagnosing fistula-in-ano, we treated them with fistulotomy and curettage, which resolved the problem.

Conclusion: When a patient presents with pain or drainage at her episiotomy site, fistula-in-ano should be considered.






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