Ijaiya M A, Rahman A G, Aboyeji A P, Olatinwo A W, Esuga S A, Ogah O K, Raji H O, Adebara I O, Akintobi A O, Adeniran A S, Adewole A A
Department of Obstetrics & Gynaecology, University of Ilorin Teaching Hospital, Maternity Hospital Wing, PMB 1339. Ilorin, Nigeria.
West Afr J Med. 2010 Sep-Oct;29(5):293-8. doi: 10.4314/wajm.v29i5.68247.
Vesicovaginal fistula is a preventable calamity, which has been an age-long menace in developing countries.
To review the causes, complications, and outcome of Vesicovaginal fistula in Nigeria.
Studies on Vesicovaginal fistula were searched on the internet. Information was obtained on PubMed(medline), WHO website, Bioline International, African Journal of Line, Google scholar, Yahoo, Medscape and e Medicine.
Many Nigerian women are living with Vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria that southern Nigeria. Obstetric fistula accounts for 84.1%-100% of the Vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9%-96.5%) in all the series. Other common causes include caesarean section, advanced cervical cancer, uterine rupture, and Gishiri cut. The identified predisposing factors were early marriage and pregnancy, which were rampant in northern Nigeria, while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance and were poverty, illiteracy, ignorance, restriction of women's movement, non-permission from husband and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87%-91.7%. Stigmatization, divorce and social exclusion were common complications. Overall fistula repair success rate was between 75% and 92% in a few centres that offer such services.
Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern.
膀胱阴道瘘是一种可预防的灾难，在发展中国家一直是长期存在的威胁。
回顾尼日利亚膀胱阴道瘘的病因、并发症及治疗结果。
在互联网上搜索关于膀胱阴道瘘的研究。信息来源于PubMed（医学文献数据库）、世界卫生组织网站、Bioline International、《非洲在线杂志》、谷歌学术、雅虎、Medscape和e Medicine。
许多尼日利亚女性患有膀胱阴道瘘。产科瘘的年发病率估计为每1000例分娩中有2.11例。在尼日利亚北部比南部更为普遍。产科瘘占膀胱阴道瘘的84.1%-100%，在所有系列中，产程延长受阻一直是最常见的原因（65.9%-96.5%）。其他常见原因包括剖宫产、晚期宫颈癌、子宫破裂和会阴侧切。已确定的诱发因素是早婚和早孕，这在尼日利亚北部很普遍，而在全国范围内，非专业接生和就医延迟很常见。导致非专业接生率高的重要因素包括贫困、文盲、无知、对妇女行动的限制、丈夫不允许以及交通问题。除一项尼日利亚研究外，所有研究均表明初产妇是最脆弱的群体。在大多数与分娩相关的病例中，妊娠结局不佳，死产率为87%-91.7%。耻辱感、离婚和社会排斥是常见的并发症。在少数提供此类服务的中心，瘘管修复的总体成功率在75%至92%之间。
膀胱阴道瘘在尼日利亚很普遍，主要与产科因素有关。这是一个值得关注的公共卫生问题。
