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产科瘘管病:尼日利亚乔斯ECWA伊瓦内福音医院VVF中心的手术经验

Obstetric fistula: the ECWA Evangel VVF Center surgical experience from Jos, Nigeria.

作者信息

Kirschner Carolyn V, Yost Kathleen J, Du Hongyan, Karshima Jonathan A, Arrowsmith Steven D, Wall L Lewis

机构信息

Department of Obstetrics & Gynecology, NorthShore University HealthSystem, Evanston, IL, USA.

出版信息

Int Urogynecol J. 2010 Dec;21(12):1525-33. doi: 10.1007/s00192-010-1231-0. Epub 2010 Aug 11.

Abstract

INTRODUCTION AND HYPOTHESIS

The objectives of this study are to analyze the surgical outcomes of women undergoing obstetric fistula repair operations at the ECWA Evangel VVF Center, Jos, Nigeria, and to identify factors associated with postoperative urinary continence.

METHODS

Sociodemographic and clinical data were abstracted retrospectively from the Center's database for patients who underwent vesicovaginal fistula (VVF) repair operations. These data were compared with clinical outcome ("wet" or "dry") at the time of hospital discharge.

RESULTS

From August 1998 to April 2004, 1,084 fistula repair operations were performed on 926 patients. A vaginal approach was used in 90.1% of cases, and postsurgical continence was achieved in 70.5% of patients. Continence was more likely in patients with an intact urethra, an upper or midvaginal fistula, and less fibrosis than in those patients who remained wet.

CONCLUSIONS

Two thirds of patients with obstetric fistulas can be cured, with complete restoration of continence and low surgical morbidity, using a transvaginal surgical approach.

摘要

引言与假设

本研究的目的是分析在尼日利亚乔斯的伊夸福音派产科瘘管修复中心接受产科瘘管修复手术的女性的手术结果,并确定与术后尿失禁相关的因素。

方法

回顾性地从该中心数据库中提取接受膀胱阴道瘘(VVF)修复手术患者的社会人口统计学和临床数据。将这些数据与出院时的临床结果(“湿”或“干”)进行比较。

结果

1998年8月至2004年4月,对926例患者进行了1084次瘘管修复手术。90.1%的病例采用经阴道入路,70.5%的患者术后实现了控尿。与仍有尿失禁的患者相比,尿道完整、阴道上或中段瘘且纤维化程度较轻的患者更易实现控尿。

结论

采用经阴道手术方法,三分之二的产科瘘患者可治愈,实现控尿的完全恢复且手术发病率低。

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