Injury of the rectum during vaginal surgery, ,

Objective: We sought to report our experience with injury of the rectum during vaginal surgery. Study Design: A retrospective chart review of a vaginal surgery database was 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 occurred just above the perineum during an attempt to develop the rectovaginal space during vaginectomy-hysterectomy for gender dysphoria. Three other injuries occurred between the vaginal cuff and peritoneum while posterior culdotomy for vaginal hysterectomy was attempted. The remaining injury was in a Schuchardt incision. All 9 injuries were recognized, repaired, and healed without complication. Conclusions: Laceration of the rectum is an uncommon complication of vaginal surgery. Prompt recognition and repair result in uncomplicated primary healing. (Am J Obstet Gynecol 1999;181:274-7.)