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尼日利亚卡拉巴尔大学教学医院妇产科泌尿生殖瘘的回顾

Review of obstetrics genito-urinary fistulae in the University of Calabar Teaching Hospital Calabar, Nigeria.

作者信息

Ekanem E I, Ekanem A D, Ekabua J E, Etuk S J, Essiet A

机构信息

Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, Nigeria.

出版信息

Niger J Clin Pract. 2010 Sep;13(3):326-30.

Abstract

BACKGROUND

Obstetric fistulae with Urinary incontinence are one of the most distressing maternal morbidities. It is associated with physical and social deprivation such as wife abandonment and violent reactions against the victims particularly in the developing countries of the world.

AIMS AND OBJECTIVES

To study the demographic and reproductive profiles as well as management of patients with obstetric fistulae in UCTH, Calabar, Nigeria.

PATIENTS AND METHOD

A five-year retrospective study of case records of 37 patients managed in Maternity Annex of University of Calabar Teaching Hospital, Calabar Nigeria for obstetric genito-urinary fistulae was carried out.

RESULTS

One in every 122 parturients during the period had fistula. Eleven (29.7%) were teenagers. Many patients were married (54.1%), nulliparous (59.4%), come from low socioeconomic class (72.9%) and did not utilize modern obstetric facilities properly. Many cases resulted from prolonged obstructed labour (51.4%) and 70.2% presented with total incontinence of urine. Eighteen (48.7%) were diagnosed within 6 month of delivery. The main types encountered included were vesico-vaginal (34.4%) or complex (10.8%) fistulae who were manage conservatively (21.6%) or with bladder repairs. Majority (29.7%) were referred for further treatment.

CONCLUSION

Parturient in Calabar still suffer from this age long obstetric morbidity mainly due to poor utilization of modern obstetric care facilities. Results of treatment are largely unsatisfactory; therefore resources should be channeled towards prevention.

摘要

背景

伴有尿失禁的产科瘘是最令人痛苦的孕产妇发病情况之一。它与身体和社会剥夺相关,如妻子被遗弃以及对受害者的暴力反应,特别是在世界上的发展中国家。

目的

研究尼日利亚卡拉巴尔大学教学医院(UCTH)产科瘘患者的人口统计学和生殖特征以及治疗情况。

患者与方法

对在尼日利亚卡拉巴尔大学教学医院产科附属楼接受治疗的37例产科泌尿生殖瘘患者的病例记录进行了为期五年的回顾性研究。

结果

在此期间,每122名产妇中就有1人患有瘘管。11名(29.7%)为青少年。许多患者已婚(54.1%)、未生育(59.4%)、来自社会经济地位较低的阶层(72.9%),且未正确使用现代产科设施。许多病例是由于产程延长受阻(51.4%)导致的,70.2%的患者表现为完全尿失禁。18名(48.7%)患者在分娩后6个月内被诊断出来。主要类型包括膀胱阴道瘘(34.4%)或复杂瘘(10.8%),这些患者接受了保守治疗(21.6%)或膀胱修复手术。大多数(29.7%)患者被转诊接受进一步治疗。

结论

卡拉巴尔的产妇仍然遭受这种由来已久的产科疾病的困扰,主要原因是现代产科护理设施利用不足。治疗结果在很大程度上并不令人满意;因此,应将资源用于预防。

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