CONGENITAL H-TYPE VESTIBULOANORECTAL FISTULA - SURGICAL ANATOMY AND AN APPROACH TO ITS MANAGEMENT

Seven girls with a congenital H-type fistula between the vestibule of the vagina and the anorectum are reported, The anus was normally place d in all cases, with the fistula opening into the anterior wall of the lower bowel at the level of the anorectal junction 2-2.5 cm above the anal verge. All seven children underwent surgical repair using a midl ine perineal approach, a preliminary sigmoid colostomy having been per formed in five cases, Satisfactory postoperative results were obtained in six patients. The anatomy and surgical management of this conditio n are discussed.