Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.
Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2019 Sep;98(9):1120-1126. doi: 10.1111/aogs.13611. Epub 2019 Apr 21.
Gynecological fistula (affecting female genital organs) leads to involuntary loss of urine or feces. In industrialized societies, fistulas occur mostly as complications of surgery, radiation therapy or inflammatory bowel disease. We sought to determine the incidence of gynecological fistula and type of surgical treatment provided in Norway.
This was a retrospective national cohort study of women treated for gynecological fistula (International Classification of Disease-10 code N82) during 2008-2014, identified from the mandatory Norwegian Patient Registry. To compare groups, we utilized Chi-square or non-parametric tests.
In all, 1627 women (.06% of the female Norwegian population) had 4475 hospital admissions with a diagnosis of gynecological fistula. In total, 1214/1627 (75%) had fistula as the main diagnosis: 346 (29%) a urogenital fistula, 672 (55%) an enterogenital, 38 (3%) a genitocutaneous and 22 (2%) both urinary and enteral fistula. Surgery for gynecological fistula was performed in 723 women, an incidence rate of 4.2 per 100 000 person-years (95% confidence interval [CI] 4.2-4.3); gynecological procedures (mostly vaginal/perineal) were performed in 163 women (23%), urological in 43 (6%), enteral in 267 (37%) and surgery involving multiple pelvic compartments in 250 (35%). Women undergoing fistula surgery had a median of three hospital contacts (95% CI 3-3), for 370 women (52%), the procedure was performed by a gynecologist, and 212 of these (29%) were also operated by urologists or gastroenterologists.
Gynecological fistula is rare in Norway, with an overall incidence of 6/10 000 in the female population, whereas the incidence of surgically treated fistula is 4.2/100 000. However, the condition represents considerable morbidity for the individual patient.
妇科瘘（影响女性生殖器官）导致尿液或粪便不由自主地流失。在工业化社会中，瘘管主要发生在手术、放射治疗或炎症性肠病的并发症中。我们试图确定挪威妇科瘘管的发病率和提供的手术治疗类型。
这是一项对 2008 年至 2014 年期间因妇科瘘（国际疾病分类第 10 版代码 N82）在挪威接受治疗的妇女进行的回顾性全国队列研究，通过强制性挪威患者登记册确定。为了比较组，我们利用了卡方或非参数检验。
共有 1627 名女性（占挪威女性人口的 0.06%）有 4475 次因妇科瘘管住院的诊断。共有 1214/1627（75%）的患者以瘘管为主要诊断：346 例（29%）为尿生殖瘘，672 例（55%）为肠生殖瘘，38 例（3%）为生殖泌尿瘘，22 例（2%）为泌尿和肠瘘。对 723 名妇科瘘管妇女进行了手术治疗，发病率为每 100000 人年 4.2 例（95%置信区间[CI]4.2-4.3）；对 163 名妇女（23%）进行了妇科手术，对 43 名妇女（6%）进行了泌尿科手术，对 267 名妇女（37%）进行了肠科手术，对 250 名妇女（35%）进行了涉及多个骨盆隔室的手术。接受瘘管手术的妇女平均有 3 次住院接触（95% CI 3-3），其中 370 名妇女（52%）的手术由妇科医生进行，其中 212 名（29%）也由泌尿科医生或胃肠病学家进行。
妇科瘘在挪威很少见，女性人群中的总体发病率为 6/10000，而经手术治疗的瘘管发病率为 4.2/100000。然而，这种情况对个别患者来说意味着相当大的发病率。
