Extrasphincteric perianal fistulae after sacrospinous fixation for apical prolapse.

Background: Delayed extrasphincteric perianal fistulae may be encountered after sacrospinous vaginal vault suspension or hysteropexy with permanent sutures.

Cases: We report two cases of extrasphincteric perianal fistulae: one after a sacrospinous vaginal vault suspension and one after a sacropsinous hysteropexy. Reproduction of the vaginal dissection performed to place the sacrospinous fixation sutures failed to expose the sutures, and the fistulae persisted.

Early experience with stapled hemorrhoidectomy in the United States.

Introduction: We report the early results of patients treated with stapled hemorrhoidectomy, which has recently been introduced into the United States.

Methods: Sixty-eight patients with symptomatic hemorrhoids were treated at two institutions with the Proximate HCS Hemorrhoidal Circular Stapler supplied by Ethicon Endo-Surgery. Patients were prospectively evaluated for functional recovery and postoperative pain on a 1 to 10 scale.