■泌尿生殖道瘘是一种身体上的,对患者的社会和心理破坏性状况。在发达国家,这些瘘通常与妇科手术有关,盆腔病理如恶性肿瘤或放射治疗后。相比之下,经典的教学是,在像印度这样的发展中国家,泌尿生殖道瘘通常与长期分娩和产科并发症有关。这项在三级保健健康研究所进行的回顾性研究显示了流行病学的范式转变,近年来印度泌尿生殖道瘘的病因和管理。
■这项回顾性研究包括2016年至2022年在我们研究所接受各种泌尿生殖道瘘手术修复的患者。流行病学,病因学,site,瘘管的大小和数量,临床表现,对这些患者的管理记录进行记录和回顾性回顾.
■在我们的研究中,患者的平均年龄为38.4±10.2岁.发现膀胱阴道瘘(VVF)是研究人群中最常见的瘘(87.5%),其次是膀胱阴道瘘(7.1%)和尿道阴道瘘(5.4%)。泌尿生殖道瘘的病因为医源性(73.2%),宫颈癌(16.1%),长期劳动受阻(7.1%),和泌尿生殖道结核(3.57%)。在接受手术的48例膀胱阴道瘘中,45.8%采用经阴道方法治疗,29.2%通过腹腔镜经腹修补术进行管理,25%的人使用机器人方法解决。7.1%的手术患者复发。
■该国医疗服务的增强有助于减少难产的发生率,减少相关伤害。妇科手术和宫颈癌引起的医源性损伤引起了更复杂的瘘管,需要实施先进的治疗策略。
UNASSIGNED: Urogenital fistula is a physically, socially and psychologically devastating condition for the patient. In developed countries, these fistulae are typically related to gynecological surgery, pelvic pathology like malignancy or post radiation therapy. In contrast, classical teaching is that urogenital fistulae in the developing countries like India are usually associated with prolonged labor and obstetric complications. This retrospective study conducted at a tertiary care health Institute shows a paradigm shift in epidemiology, etiology and management of genitourinary fistulae in India in recent times.
UNASSIGNED: This retrospective study included patients undergoing surgical repair for various genitourinary fistulae at our institute from 2016 to 2022. Epidemiology, etiology, site, size and number of fistulae, clinical presentation, and management records of these patients were recorded and reviewed retrospectively.
UNASSIGNED: In our study, the mean age of the patients was 38.4 ± 10.2 years. Vesicovaginal Fistula (VVF) was found to be most common fistula in the study population (87.5%) followed by vesicouterine (7.1%) and urethrovaginal fistula (5.4%). The causes of genitourinary fistula were iatrogenic (73.2%), carcinoma of cervix (16.1%), obstructed prolonged labor (7.1%), and genitourinary tuberculosis (3.57%). Among the 48 vesicovaginal fistulas that underwent surgery, 45.8% were treated using a transvaginal approach, 29.2% were managed through a laparoscopic transabdominal repair, and 25% were addressed using a robotic approach. Recurrence occurred in 7.1% of the operated patients.
UNASSIGNED: Enhanced healthcare services in the country have contributed to a decrease in the incidence of obstructed labor, subsequently reducing related injuries. Iatrogenic injuries resulting from gynecological surgeries and carcinoma cervix have given rise to more complex fistulas, necessitating the implementation of advanced treatment strategies.