Fistula-in-ano after episiotomy

Background: In the past 2 years, we treated three women with fourth-degree lacerations or episiotomy infections presenting with persistent pain and dr ainage 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 fis tulotomy 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. (Obstet Gynecol 1999;93:800-2. (C) 1999 by The American College of Obstetricians and Gynecologists.).