Brown Heidi W, Wang Li, Bunker Clareann H, Lowder Jerry L
Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Int Urogynecol J. 2012 Apr;23(4):403-10. doi: 10.1007/s00192-011-1653-3. Epub 2012 Jan 26.
The objective of the study was to characterize trends in lower reproductive tract fistula (LRTF) repair in inpatient US women from 1979 to 2006.
Retrospective data was obtained from the National Hospital Discharge Survey regarding LRTF diagnoses, demographics, comorbidities, and fistula repair procedures, using ICD-9-CM diagnostic and procedure codes. Age-adjusted rates (AARs) were calculated using 1990 census data. Trends in LRTF surgical repair were evaluated using regression analysis.
Between 1979 and 2006, the AAR of LRTF repair declined from 7.8 to 4.8 per 100,000 women (b = -2.97, p < 0.001). The most common surgical fistula repairs were rectovaginal, vesicovaginal, and colovaginal. The AARs of colovaginal and vesicovaginal fistula repair remained stable, while the AAR of rectovaginal fistula repair declined.
The AAR of inpatient LRTF repair declined between 1979 and 2006, perhaps reflecting a concurrent decrease in obstetric trauma, in the context of decreasing episiotomy and operative vaginal delivery and increasing cesarean section rates.
本研究的目的是描述1979年至2006年美国住院女性下生殖道瘘（LRTF）修复手术的趋势。
使用ICD - 9 - CM诊断和手术编码，从国家医院出院调查中获取有关LRTF诊断、人口统计学、合并症和瘘管修复手术的回顾性数据。年龄调整率（AARs）采用1990年人口普查数据计算。使用回归分析评估LRTF手术修复的趋势。
1979年至2006年期间，LRTF修复的AAR从每10万名女性7.8例降至4.8例（b = -2.97，p < 0.001）。最常见的手术瘘管修复是直肠阴道瘘、膀胱阴道瘘和结肠阴道瘘。结肠阴道瘘和膀胱阴道瘘修复的AAR保持稳定，而直肠阴道瘘修复的AAR下降。
1979年至2006年期间，住院LRTF修复的AAR下降，这可能反映了在会阴切开术和手术阴道分娩减少以及剖宫产率增加的情况下，产科创伤同时减少。
