Lawson J
University of Ibadan, Nigeria.
Trans R Soc Trop Med Hyg. 1989 Jul-Aug;83(4):454-6. doi: 10.1016/0035-9203(89)90244-7.
The predominantly obstetric origin of vesico-vaginal fistulae in the tropics is contrasted with the mainly surgical aetiology of those in Europe by analysis of 543 cases treated in Nigeria and in the United Kingdom. Reasons are given for the high incidence in tropical countries of obstructed labour and hence of vesico-vaginal fistulae. The general management of patients with obstetric fistulae is described, followed by the principles of their surgical treatment and postoperative nursing care. The importance of success at the first attempt at repair is stressed, and the small place for managing failures by urinary diversion is mentioned. It is concluded that obstetric fistulae should be preventable in the tropics, having now been effectively eliminated from industrialized countries.
通过对在尼日利亚和英国接受治疗的543例病例进行分析，对比了热带地区膀胱阴道瘘主要源于产科与欧洲主要由手术病因导致的情况。文中给出了热带国家产程梗阻发生率高以及由此导致膀胱阴道瘘发生率高的原因。描述了产科瘘患者的一般管理，接着阐述了手术治疗原则及术后护理。强调了首次修复成功的重要性，并提及了通过尿流改道处理修复失败情况的有限作用。得出结论：产科瘘在热带地区应是可预防的，而在工业化国家现已有效消除。
