Maternity Africa, Arusha, Tanzania.
Ministry of Health, Addis Ababa, Ethiopia.
BJOG. 2018 May;125(6):745-749. doi: 10.1111/1471-0528.14953. Epub 2017 Nov 17.
Our aim was to describe a new surgical method for prophylaxis/cure of post obstetric fistula repair leakage based on restoring vaginal elasticity with Singapore skin flap. The rationale for this operation was based on the integral theory: scarring removes elasticity required for independent function of oppositely acting urethral closure forces so they become 'tethered, forcibly opening the urethra when give the signal to close'. Skin graft restores elasticity and closure. Used prophylactically with Goh type 4 fistula (n = 45), 46% were dry against an expected 19%. In patients with successful fistula closure, still with severe leakage (n = 24), 71% were dry against an expected 26%.
Singapore skin flap restores elasticity and prevents and treats incontinence in patients with successful obstetric fistula repair.
基于利用新加坡皮瓣恢复阴道弹性，描述一种新的产科瘘修补术后漏诊/治疗的外科方法。该手术的原理基于整体理论：瘢痕组织会去除相反作用的尿道闭合力所需的弹性，使它们“束缚”，当需要关闭尿道时会强行打开尿道”。皮瓣移植可恢复弹性和闭合功能。预防性应用于 Goh 四型瘘（n=45），46%的患者干燥，预期为 19%。在成功闭合瘘管但仍有严重渗漏的患者中（n=24），71%的患者干燥，预期为 26%。
新加坡皮瓣可恢复弹性，预防和治疗产科瘘修补术后成功患者的尿失禁。
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