METHODS: A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Two reviewers screened abstracts and full-text and extracted data independently. A narrative synthesis was conducted given the heterogeneity of studies.
RESULTS: A total of 1032 studies were identified after searching the database, and 14 articles were included in this systematic review. Of the 84 women included, 12 (14.3%) presented failure or recurrence of their fistula tract. The mean time of follow-up was 11.46 months. The average size of the fistula was 1.05 (range 0.1 to 3.9) cm. Most fistulas (81) included were vesicovaginal fistulas. Nine papers reported the usage of fibrin glue in which only three (6.5%) women reported recurrence of the fistula in a delay of 2 weeks to 26 months. The other studies used cyanoacrylate (14 women) and autologous fibrin injection from the patients\' blood (31 women). No significant complications were reported. Complications reported were urinary tract infections in 3 women (3.6%), hematuria in 2 women (2.4%), overactive bladder symptoms in 6 women (7.2%) and septic pelvic thrombosis in one woman (1.2%).
CONCLUSIONS: Tissue adhesive appears to be a promising alternative for management of urogenital fistulas without reported important complications.
方法:根据系统评价和荟萃分析(PRISMA)声明的首选报告项目对文献进行系统综述。两名审稿人筛选摘要和全文,并独立提取数据。鉴于研究的异质性,进行了叙事综合。
结果:在搜索数据库后,共确定了1032项研究,本系统综述纳入了14篇文章.包括84名女性,12例(14.3%)出现瘘管失败或复发。平均随访时间为11.46个月。瘘管的平均大小为1.05(范围为0.1至3.9)cm。大多数瘘管(81)包括膀胱阴道瘘。9篇论文报道了纤维蛋白胶的使用,其中只有3名(6.5%)妇女报告了瘘的复发,延迟了2周至26个月。其他研究使用氰基丙烯酸酯(14名女性)和患者血液中自体纤维蛋白注射(31名女性)。无明显并发症报告。报告的并发症是3名女性(3.6%)的尿路感染,2名女性血尿(2.4%),6名女性(7.2%)出现膀胱过度活动症,1名女性(1.2%)出现脓毒性盆腔血栓。
结论:组织粘合剂似乎是治疗泌尿生殖道瘘的一种有希望的替代方法,没有报告的重要并发症。