Introduction and hypothesis: Unsuccessful primary repair of fourth-degree obstetric trauma can lead to permanent communication between the rectum and the vagina, which, in association with full-thickness anal sphincter defects, is characterized by complete fecal incontinence and severe impairment of quality of life. The aim of this video is to serve as a tutorial for repair.
Methods: A 27-year-old woman who developed a full-thickness recto-vaginal defect extended from the perineum to the upper third of the vagina has been managed through layered surgical repair without flaps.
Results: Anatomy and fecal continence have been completely restored by a follow-up of 24 months.
Conclusion: The procedure described in this video has been shown to be effective and safe.
Keywords: Obstetric anal sphincter injury; Surgical repair; Traumatic cloaca.