Recurrent posttraumatic urethro-vaginal fistula: A new application for ASTRA

The authors describe the results of an application of the surgical techniqu e called ASTRA (anterior sagittal transrectal approach) in a 16-year-old gi rl with recurrent urethro-vaginal fistula. The young girl had a posttraumat ic urethro-vaginal fistula. It recurred after 4 operations by a direct vagi nal approach before definitive correction with the ASTRA. Three years after the operation the patient has remained well with complete healing and no f istula recurrence confirmed by a voiding cystourethrogram and urodynamic an d rectal manometric tests. This report suggests that ASTRA is a useful meth od of treating acquired or developmental anomalies of the perineal region. J Pediatr Surg 34:1865-1868. Copyright (C) 1999 by W.B. Saunders Company.