Ouedraogo Itengre, McConley Regina, Payne Christopher, Heller Alison, Wall L Lewis
Danja Fistula Center, Danja, Niger.
Vista Urology and Pelvic Pain Partners, San Jose, CA, USA.
Int Urogynecol J. 2018 Mar;29(3):363-368. doi: 10.1007/s00192-017-3370-z. Epub 2017 Jun 19.
The objective was to determine the contribution of female genital cutting to genital fistula formation in Niger from the case records of a specialist fistula hospital.
A retrospective review was undertaken of the records of 360 patients seen at the Danja Fistula Center, Danja, Niger, between March 2014 and September 2016. Pertinent clinical and socio-demographic data were abstracted from the cases identified.
A total of 10 fistulas resulting from gurya cutting was obtained: 9 cases of urethral loss and 1 rectovaginal fistula. In none of the cases was genital cutting performed for obstructed labor or as part of ritual coming-of-age ceremonies, but all cutting procedures were considered "therapeutic" within the local cultural context as treatment for dyspareunia, lack of interest in or unwillingness to engage in sexual intercourse, or female behavior that was deemed to be culturally inappropriate by the male spouse, parents, or in-laws. Clinical cure (fistula closed and the patient continent) was obtained in all 10 cases, although 3 women required more than one operation.
Gurya cutting is an uncommon, but preventable, cause of genital fistulas in Niger. The socio-cultural context which gives rise to gurya cutting is explored in some detail.
目的是根据一家专业瘘管医院的病例记录，确定在尼日尔女性生殖器切割对生殖道瘘形成的影响。
对2014年3月至2016年9月期间在尼日尔丹贾瘘管中心就诊的360例患者的记录进行回顾性研究。从确诊病例中提取相关临床和社会人口学数据。
共发现10例因古里亚切割导致的瘘管：9例尿道缺失和1例直肠阴道瘘。所有病例中，生殖器切割均非因难产或作为成年仪式的一部分进行，但在当地文化背景下，所有切割手术均被视为“治疗性”的，用于治疗性交困难、对性交缺乏兴趣或不愿意进行性交，或男性配偶、父母或姻亲认为在文化上不适当的女性行为。10例患者均实现临床治愈（瘘管闭合且患者控尿），尽管有3名女性需要进行不止一次手术。
在尼日尔，古里亚切割是导致生殖道瘘的一个罕见但可预防的原因。文中对导致古里亚切割的社会文化背景进行了较为详细的探讨。
