产科瘘的外科分类。

Surgical classification of obstetric fistulas.

作者信息

Waaldijk K

机构信息

Laure Fistula Center, Murtala Muhammad Specialist Hospital, Kano, Nigeria.

出版信息

Int J Gynaecol Obstet. 1995 May;49(2):161-3. doi: 10.1016/0020-7292(95)02350-l.

DOI:10.1016/0020-7292(95)02350-l

PMID:7649321

Abstract

OBJECTIVE

To develop a surgical classification for obstetric fistulas in order to compare surgical techniques and results.

METHODS

Based on a retrospective analysis of 775 consecutive fistula patients, the following classification is presented: (type I) fistulas not involving the urethral closing mechanism; (type II) fistulas involving the urethral closing mechanism; and (type III) ureter and other exceptional fistulas. Type II fistulas can be further divided into: (A) without (sub)total urethra involvement, and (B) with (sub)total urethra involvement; and (a) without a circumferential defect, and (b) with a circumferential defect. This classification was applied prospectively in over 2700 consecutive fistula patients.

RESULTS

The surgical technique becomes progressively more complicated from type I through type IIBb. The results of closure and continence worsen progressively from type I through type IIBb. Personal experience in the case of type III fistulas is very limited.

CONCLUSION

This classification enables a systematic comparison of different surgical techniques and an objective evaluation of results from different centers.

摘要

目的

制定一种产科瘘管的手术分类方法，以便比较手术技术和结果。

方法

基于对775例连续瘘管患者的回顾性分析，提出以下分类：（I型）不涉及尿道闭合机制的瘘管；（II型）涉及尿道闭合机制的瘘管；（III型）输尿管及其他特殊瘘管。II型瘘管可进一步分为：（A）无（次）全尿道受累，（B）有（次）全尿道受累；以及（a）无环形缺损，（b）有环形缺损。该分类方法前瞻性地应用于2700多例连续瘘管患者。