Waaldijk K
Laure Fistula Center, Murtala Muhammad Specialist Hospital, Kano, Nigeria.
Int J Gynaecol Obstet. 1994 Apr;45(1):11-6. doi: 10.1016/0020-7292(94)90759-5.
To determine prospectively if the immediate surgical management of obstetric fistulas within the first 3 months by catheter and/or early closure is effective.
During a 10-month period (August 1992 through May 1993), a total of 170 patients with an obstetric fistula of less than 3 months' duration were treated. A catheter was inserted if the fistula was necrotic, and as soon as the fistula edge was clean an early closure was performed unless the fistula had healed already.
The fistula was closed in 156 (91.8%) of the 170 consecutive patients: with continence in 146 (93.6%), minimal/mild incontinence in 7 (4.5%) and severe incontinence in 3 (1.9%) of the closed fistulas. In 14 patients (8.2%) the fistula was not closed at first intention; however, 12 were closed at the second attempt.
The immediate surgical management proved highly effective in terms of closure and continence.
前瞻性地确定在最初3个月内通过导管插入和/或早期缝合对产科瘘进行即时手术治疗是否有效。
在10个月期间（1992年8月至1993年5月），共治疗了170例病程少于3个月的产科瘘患者。如果瘘管坏死则插入导管，一旦瘘管边缘清洁，除非瘘管已经愈合，否则立即进行早期缝合。
170例连续患者中有156例（91.8%）的瘘管得以闭合：其中146例（93.6%）实现控尿，7例（4.5%）为轻度/中度尿失禁，3例（1.9%）闭合瘘管后仍有重度尿失禁。14例（8.2%）患者的瘘管一期未闭合；然而，12例在二次尝试时闭合。
即时手术治疗在瘘管闭合和控尿方面证明非常有效。
