Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo.
Université Evangelique en Afrique, Bukavu, Democratic Republic of Congo.
Int J Gynaecol Obstet. 2022 Jan;156(1):145-150. doi: 10.1002/ijgo.13684. Epub 2021 May 12.
To describe the care pathway of patients with pelvic organ prolapse in a high-volume resource-limited setting and characterize patients undergoing surgery.
The patient care pathway at a large referral hospital in eastern Democratic Republic of Congo was determined through interviews with key personnel. Patients with apical prolapse (with or without anterior/posterior prolapse) who underwent surgery between January and December 2018 were included. Demographics and outcomes were characterized. Data were presented as means (standard deviation [SD]), medians (interquartile range), or number (percentages).
A holistic care model was described. During the study period, 772 patients underwent prolapse repairs, 235 met inclusion criteria. Mean age was 55 (±14) years, and 75% (176/235) were postmenopausal. Median parity was 7 (5-9). A majority (56%, 131/233) had body mass index <18.5 (calculated as weight in kilograms divided by the square of height in meters). Most were farmers (77%, 182/235) and had no formal education (76%, 178/235). Postmenopausal patients underwent hysterectomy, whereas premenopausal patients were treated with uterine-preserving techniques. Most repairs were performed vaginally (96%, 225/235), and 40% (94/234) had concurrent multicompartment repairs. Most common complications were hemorrhage (4%, 9/235, intraoperative) and urinary tract infection (5%, 11/235, postoperative).
High-volume surgical services for treating prolapse can be integrated into existing healthcare delivery models. Our demographic of patients differs from studies in high-income countries. The degree to which these studies can be generalized to patients in settings similar to ours represents an opportunity for further research.
描述资源有限的大容量环境中盆腔器官脱垂患者的护理路径，并描述接受手术治疗的患者特征。
通过对刚果民主共和国东部一家大型转诊医院的关键人员进行访谈，确定患者的护理路径。纳入 2018 年 1 月至 12 月期间接受过手术治疗的顶端脱垂（伴或不伴前/后脱垂）患者。描述患者的人口统计学和结局特征。数据以平均值（标准差 [SD]）、中位数（四分位间距）或数量（百分比）呈现。
描述了一种整体护理模式。研究期间，772 例患者接受了脱垂修复术，235 例符合纳入标准。平均年龄为 55（±14）岁，75%（176/235）处于绝经后状态。中位产次为 7（5-9）。大多数患者（56%，131/233）的体重指数（BMI）<18.5（体重以千克为单位，除以身高的平方以米为单位）。大多数患者为农民（77%，182/235），没有受过正规教育（76%，178/235）。绝经后患者行子宫切除术，而绝经前患者则采用保留子宫的技术进行治疗。大多数手术采用阴道入路（96%，225/235），40%（94/234）同时进行多部位修复。最常见的并发症是出血（4%，9/235，术中）和尿路感染（5%，11/235，术后）。
大量的脱垂手术治疗服务可以整合到现有的医疗保健提供模式中。我们的患者人群与高收入国家的研究不同。这些研究在多大程度上可以推广到与我们相似环境中的患者，这是进一步研究的机会。
