Repair of a traumatic cloaca after obstetric anal sphincter injury

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.