Obi S N, Ozumba B C, Onyebuchi A K
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
J Obstet Gynaecol. 2008 Aug;28(6):629-31. doi: 10.1080/01443610802397686.
This study retrospectively reviewed 476 cases of vesico-vaginal fistula (VVF) in the University of Nigeria Teaching Hospital Enugu, south-east Nigeria from 1981 to 2005. The majority (86.6%) of the VVFs were of obstetric origin, resulting from vaginal delivery (n = 330), caesarean section (n = 35), caesarean hysterectomy (n = 26) and instrumental delivery (n = 21). The remaining 13.4% (n = 64) resulted from pelvic surgery, malignancy and radiotherapy treatment. The contribution of obstetrics to VVF development showed a downward trend from 95% in 1981 to 60% in 2005. A success rate of 83% was recorded in the repair with large sized fistula and extensive fibrosis at the fistula site contributing mostly to failure. There is a need to increase access to trained delivery attendants to sustain the downward trend in the incidence of VVF.
本研究回顾性分析了1981年至2005年期间尼日利亚东南部埃努古尼日利亚大学教学医院收治的476例膀胱阴道瘘（VVF）病例。大多数（86.6%）膀胱阴道瘘源于产科，由阴道分娩（n = 330）、剖宫产（n = 35）、剖宫产子宫切除术（n = 26）和器械助产（n = 21）所致。其余13.4%（n = 64）由盆腔手术、恶性肿瘤及放疗引起。产科因素导致膀胱阴道瘘的比例从1981年的95%呈下降趋势至2005年的60%。大型瘘管修补成功率为83%，瘘管部位广泛纤维化是导致失败的主要原因。有必要增加获得专业接生人员服务的机会，以维持膀胱阴道瘘发病率的下降趋势。
