Creanga A A, Genadry R R
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
Int J Gynaecol Obstet. 2007 Nov;99 Suppl 1:S40-6. doi: 10.1016/j.ijgo.2007.06.021. Epub 2007 Sep 14.
A high proportion of genitourinary fistulas have an obstetric origin. Obstetric fistulas are caused by prolonged obstructed labor coupled with a lack of medical attention. While successful management with prolonged bladder drainage has occasionally been reported, mature fistulas require formal operative repair, and it is crucial that the first repair is done properly. The literature reports 3 approaches to fistula repair: vaginal, abdominal, and combined vaginal and abdominal. Many authors report high success rates for the surgical closure of obstetric fistulas at the time of hospital discharge, without further evaluation of the repair's effect on urinary continence or subsequent quality of life. Data on obstetric fistulas are scarce, and thus many questions regarding fistula management remain unanswered. A standardized terminology and classification, as well as a data reporting system on the surgical management of obstetric fistulas and its outcomes, are critical steps that need to be taken immediately.
很大一部分泌尿生殖瘘起源于产科。产科瘘是由产程延长受阻并缺乏医疗护理所致。虽然偶尔有关于通过长期膀胱引流成功治疗的报道，但成熟的瘘需要进行正规的手术修复，首次修复操作得当至关重要。文献报道了瘘修复的3种方法：经阴道、经腹以及经阴道和腹部联合。许多作者报告产科瘘手术闭合在出院时成功率很高，但未进一步评估修复对尿失禁或后续生活质量的影响。关于产科瘘的数据稀缺，因此许多关于瘘管理的问题仍未得到解答。标准化的术语和分类，以及关于产科瘘手术管理及其结果的数据报告系统，是亟待立即采取的关键步骤。
