Munoz Oxana, Bowling C Bryce, Gerten Kimberly A, Taryor Rebecca, Norman Andy M, Szychowski Jeff M, Richter Holly E
Department of Surgery, Division of Urology, University of Alabama, Birmingham; Birmingham, AL.
Br J Med Surg Urol. 2011 Nov;4(6):259-265. doi: 10.1016/j.bjmsu.2011.02.001.
To assess factors influencing short-term outcomes of vesicovaginal fistula (VVF) repairs in community-dwelling women of Liberia, Africa. METHODS: Forty patients who underwent VVF repairs were analyzed. Primary outcome was continence status at 14 days post repair. Factors influencing continence status were characterized. RESULTS: The mean duration of leakage was 9.6 ± 8.3 years, (3 months-28 years). Thirteen (33%) had previous repairs, and 6 (15%) had multiple fistula sites. Twenty-eight (70%) were continent at catheter removal. First time repairs had a higher continence rate compared to women with previous repairs, 78% and 54% respectively (p= 0.15). Seven (47%) juxtaurethral repairs were considered failures, while only one (9%) juxtacervical fistulas remained incontinent (p= 0.069). Controlling for duration of leakage, women with previous repairs were significantly less likely to be continent (p = 0.04; adjusted OR = 0.07; 95% CI: 0.005, 0.83). CONCLUSIONS: Patients with previous VVF repairs and juxtaurethral fistulae experience lower success rates; surgery remains an effective treatment for many VVF patients.
评估影响非洲利比里亚社区居住女性膀胱阴道瘘（VVF）修复短期结局的因素。方法：对40例行VVF修复的患者进行分析。主要结局是修复后14天的控尿状态。对影响控尿状态的因素进行了描述。结果：漏尿的平均持续时间为9.6±8.3年（3个月至28年）。13例（33%）曾接受过修复，6例（15%）有多个瘘口部位。28例（70%）在拔除导尿管时实现控尿。首次修复的控尿率高于曾接受过修复的女性，分别为78%和54%（p = 0.15）。7例（47%）尿道旁修复被视为失败，而只有1例（9%）宫颈旁瘘仍存在尿失禁（p = 0.069）。在控制漏尿持续时间后，曾接受过修复的女性实现控尿的可能性显著降低（p = 0.04；调整后的OR = 0.07；95%CI：0.005，0.83）。结论：曾接受过VVF修复的患者和尿道旁瘘患者成功率较低；手术对许多VVF患者仍然是一种有效的治疗方法。
