Injury of the rectum during vaginal surgery

OBJECTIVE: We sought to report our experience with injury of the rectum dur ing vaginal surgery. STUDY DESIGN: A retrospective chart review of a vaginal surgery database wa s performed. RESULTS: Nine injuries were identified. Four patients with posthysterectomy vault prolapse incurred a rectal laceration just above the perineum during an attempt to develop the rectovaginal space. Another rectal laceration oc curred just above the perineum during an attempt to develop the rectovagina l space during vaginectomy-hysterectomy for gender dysphoria. Three other i njuries occurred between the vaginal cuff and peritoneum while posterior cu ldotomy for vaginal hysterectomy was attempted. The remaining injury was in a Schuchardt incision. All 9 injuries were recognized, repaired, and heale d without complication. CONCLUSIONS: Laceration of the rectum is an uncommon complication of vagina l surgery. Prompt recognition and repair result in uncomplicated primary he aling.