Javed Atif, Abdullah Aziz, Faruqui Nuzhat, Syed Sher Shah, Pirzada Abdul Jabbar
Urology Ward, Wajid Ali Shah Complex, Liaquat National Hospital, Karachi.
Section of Urology, Department of Surgery, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2015 Sep;65(9):954-9.
To evaluate various prognostic factors which determine outcome after surgical repair of vesicovaginal fistula.
The retrospective study was conducted at Koohi Goth Fistula Hospital, Karachi, and comprised data related to patients having undergone vesicovaginal fistula repair from January 2007 to June 2012. Multivariate analysis of the record was done using SPSS 19 software determining odds ratio with 95% confidence interval.
Record of 640 patients were analysed with an overall success in 558(87.2%) cases. Multivariate analysis determined that the recurrence of vesicovaginal fistula was significantly related to multiplicity (9-fold recurrence risk), pre-operative size (10-fold recurrence risk for fistula >2cm compared to <1cm), secondary repair (5-fold risk) and duration of the fistula (3-fold risk).Interposition of flap and delayed reconstruction (between 6 weeks and 1 year) was related to successful surgical outcome. Age, parity, aetiology, route of repair and location of fistula were not significant (p>0.05 each) prognostic factors for recurrence.
Successful surgical repair of vesicovaginal fistula require careful evaluation of various factors, including number, size, previous attempts to surgical repair and duration of fistula.
评估决定膀胱阴道瘘手术修复后预后的各种因素。
本回顾性研究在卡拉奇的库希戈特瘘管医院进行，纳入了2007年1月至2012年6月期间接受膀胱阴道瘘修复手术患者的数据。使用SPSS 19软件对记录进行多因素分析，确定比值比及95%置信区间。
分析了640例患者的记录，558例（87.2%）总体手术成功。多因素分析确定，膀胱阴道瘘复发与瘘管数量（复发风险高9倍）、术前瘘口大小（瘘口>2cm相比<1cm复发风险高10倍）、二次修复（风险高5倍）及瘘管持续时间（风险高3倍）显著相关。皮瓣置入和延迟重建（6周与1年之间）与手术成功结果相关。年龄、产次、病因、修复途径及瘘管位置并非复发的显著预后因素（各p>0.05）。
膀胱阴道瘘手术成功修复需要仔细评估各种因素，包括瘘管数量、大小、既往手术修复尝试及瘘管持续时间。
