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女性盆底医学和重建外科学的能力建设:埃塞俄比亚瘘管护理之外的全球健康伙伴关系。

Capacity building in female pelvic medicine and reconstructive surgery: Global Health Partnership beyond fistula care in Ethiopia.

机构信息

Oregon Health & Science University, L466, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.

Kaiser Permanente Northwest, Portland, OR, USA.

出版信息

Int Urogynecol J. 2020 Feb;31(2):227-235. doi: 10.1007/s00192-019-04197-0. Epub 2020 Jan 3.

DOI:10.1007/s00192-019-04197-0
PMID:31900548
Abstract

OBJECTIVE

Obstetric fistula is a devastating childbirth injury that leaves women incontinent, stigmatized and often isolated from their families and communities. In Ethiopia, although much attention has focused on treating and preventing obstetric fistula, other more prevalent childbirth-related pelvic floor disorders, such as pelvic organ prolapse, non-fistula-related incontinence and post-fistula residual incontinence, remain largely unattended. The lack of international and local attention to addressing devastating pelvic floor disorders is concerning for women in low- and middle-income countries. The objective of this article is to highlight the need for a more comprehsive approach to pelvic floor care and to share our experience in addressing it.

METHODS

Here, we share our experience launching one of the first formal training programs in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) in Ethiopia.

RESULTS

This fellowship program provides quality care while strengthening the health system in its local context. This program has positioned Ethiopia to be a regional leader by providing comprehensive training of surgeons and allied health professionals, building appropriate health system and research infrastructure, and developing a formal FPMRS training curriculum.

CONCLUSION

We hope that sharing this experience will serve as a template for others championing comprehensive pelvic floor care for women in low- and middle-income countries.

摘要

目的

产科瘘是一种毁灭性的分娩损伤,导致女性失禁、受辱,并常常与家人和社区隔离。在埃塞俄比亚,尽管人们对产科瘘的治疗和预防给予了极大关注,但其他更常见的分娩相关盆底功能障碍,如盆腔器官脱垂、非瘘相关尿失禁和瘘后残余性尿失禁,仍在很大程度上未得到关注。国际和当地对解决毁灭性盆底功能障碍的关注不足,令人关切的是,这对中低收入国家的妇女产生影响。本文的目的是强调需要采取更全面的方法来进行盆底护理,并分享我们在这方面的经验。

方法

在这里,我们分享了在埃塞俄比亚开展第一个女性盆底医学和重建外科(Female Pelvic Medicine and Reconstructive Surgery,FPMRS)正式培训项目之一的经验。

结果

该研究员项目在加强当地卫生系统的同时提供了高质量的护理。该项目通过为外科医生和相关医疗专业人员提供全面培训、建立适当的卫生系统和研究基础设施以及制定正式的 FPMRS 培训课程,使埃塞俄比亚在该地区处于领先地位。

结论

我们希望分享这一经验,为其他在中低收入国家为妇女提供全面盆底护理的倡导者提供模板。

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本文引用的文献

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Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study.产后膀胱阴道瘘修补术后的尿控、生活质量和抑郁:一项队列研究。
BJOG. 2019 Jun;126(7):926-934. doi: 10.1111/1471-0528.15546. Epub 2018 Dec 27.
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High-quality health systems in the Sustainable Development Goals era: time for a revolution.可持续发展目标时代的高质量卫生系统:是时候进行一场变革了。
Lancet Glob Health. 2018 Nov;6(11):e1196-e1252. doi: 10.1016/S2214-109X(18)30386-3. Epub 2018 Sep 5.
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Life after pelvic organ prolapse surgery: a qualitative study in Amhara region, Ethiopia.
国际学术医学伙伴关系的增长模式:加纳妇产科研究生培训项目的定性分析
PLOS Glob Public Health. 2023 Jan 12;3(1):e0000546. doi: 10.1371/journal.pgph.0000546. eCollection 2023.
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The Siege of Ayder Hospital: A Cri de Coeur From Tigray, Ethiopia.《艾达儿医院围困事件:来自埃塞俄比亚提格雷的呐喊》。
Female Pelvic Med Reconstr Surg. 2022 May 1;28(5):e137-e141. doi: 10.1097/SPV.0000000000001181. Epub 2022 Apr 15.
5
Provider Perspectives on Persistent Urinary Incontinence Following Obstetric Fistula Repair in Ethiopia.埃塞俄比亚产科瘘修补术后持续性尿失禁的提供者观点
Front Glob Womens Health. 2020 Oct 15;1:557224. doi: 10.3389/fgwh.2020.557224. eCollection 2020.
盆腔器官脱垂手术后的生活:埃塞俄比亚阿姆哈拉地区的一项定性研究
BMC Womens Health. 2018 May 29;18(1):74. doi: 10.1186/s12905-018-0568-2.
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Systematic review and meta-analysis of prevalence of, and risk factors for, pelvic floor disorders in community-dwelling women in low and middle-income countries: a protocol study.低收入和中等收入国家社区居住女性盆底功能障碍患病率及危险因素的系统评价与荟萃分析:一项方案研究
BMJ Open. 2017 Jun 8;7(6):e015626. doi: 10.1136/bmjopen-2016-015626.
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Pelvic organ prolapse: the impact on quality of life and psychological well-being.盆腔器官脱垂:对生活质量和心理健康的影响。
J Psychosom Obstet Gynaecol. 2018 Jun;39(2):164-166. doi: 10.1080/0167482X.2017.1294155. Epub 2017 Mar 1.
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Residual Incontinence After Obstetric Fistula Repair.产科瘘修补术后的残余尿失禁
Obstet Gynecol. 2016 Nov;128(5):943-944. doi: 10.1097/AOG.0000000000001734.
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The changing face of obstetric fistula surgery in Ethiopia.埃塞俄比亚产科瘘管病手术不断变化的面貌。
Int J Womens Health. 2016 Jul 1;8:243-8. doi: 10.2147/IJWH.S106645. eCollection 2016.
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Prevalence of obstetric fistula and symptomatic pelvic organ prolapse in rural Ethiopia.埃塞俄比亚农村地区产科瘘和有症状盆腔器官脱垂的患病率
Int Urogynecol J. 2016 Jul;27(7):1063-7. doi: 10.1007/s00192-015-2933-0. Epub 2016 Jan 11.
9
The Emotional Burden of Pelvic Organ Prolapse in Women Seeking Treatment: A Qualitative Study.寻求治疗的女性盆腔器官脱垂的情感负担:一项定性研究。
Female Pelvic Med Reconstr Surg. 2015 Nov-Dec;21(6):332-8. doi: 10.1097/SPV.0000000000000190.
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Prevalence of symptoms of vaginal fistula in 19 sub-Saharan Africa countries: a meta-analysis of national household survey data.撒哈拉以南非洲 19 个国家阴道瘘症状的患病率:国家家庭调查数据的荟萃分析。
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