背景:产科瘘是由产科并发症引起的生殖道与下泌尿和/或胃肠道之间的异常开口,影响了全世界近200万女性。它强加了物理,经济,社会,以及对受影响妇女的心理后果。治疗结果各不相同,大多数情况下,手术治疗可改善存活者的生活质量,并成功再次妊娠.
目的:本综述旨在绘制和检查中低收入国家产科瘘外科修复的治疗结果。
方法:这是一项范围审查研究,旨在确定中低收入国家产科瘘手术修复的治疗结果。搜索是从数据库中进行的(PUBMED,Embase,CINAHL,Scopus,和WebofScience),和灰色文学(谷歌学者,Google,和会议记录)。
方法:资格标准是使用参与者构建的,概念,和背景框架,并包括主要研究的研究类型,reviews,和报告。没有全文和英语以外语言的研究被排除在外。
方法:在Excel电子表格中提取纳入研究的相关特征,并进行分析以绘制治疗结果。
结果:本综述审查了57项关于产科瘘治疗结果的研究全文。研究结果分为两个主题:早期结果和晚期结果。早期结果包括尿失禁,手术部位感染,尿潴留,出血,并保留导管。晚期结果包括瘘管复发,残余失禁,生活质量,生殖问题,心理健康,家庭和社会支持,和财务状况。
结论:产科瘘的治疗结果可分为短期和长期结果。尽管这篇综述发现了足够的分析研究,大多数研究设计都很糟糕。建议将来进行更强有力的研究,以指导政策和决策。我们建议研究人员对短期和长期结果独立进行系统评价和荟萃分析。
BACKGROUND: Obstetrical fistula is an abnormal opening between the reproductive tract and lower urinary and/or gastrointestinal tract resulting from
obstetrical complications, affecting nearly two million women worldwide. It imposes physical, economic, social, and mental consequences on the affected women. Treatment outcomes vary and, mostly, surgical treatment results in improved quality of life and successful subsequent pregnancy for survivors.
OBJECTIVE: The review aimed to chart and examine the treatment outcomes of
obstetrical fistula surgical repair in low- and middle-income countries.
METHODS: This is a scoping review study to identify treatment outcomes of
obstetrical fistula surgical repair in low- and middle-income countries. The search was conducted from databases (PUBMED, Embase, CINAHL, Scopus, and Web of Science), and gray literature (Google Scholar, Google, and conference proceedings).
METHODS: The eligibility criteria were constructed using a participant, concept, and context framework and included study types of primary research, reviews, and reports. Studies without full text and in languages other than English were excluded.
METHODS: The relevant characteristics of the included studies were extracted on an Excel spreadsheet and analyzed to chart treatment outcomes.
RESULTS: The review examined the full text of 57 studies on the treatment outcomes of obstetrical fistula. The findings were grouped into two themes: early and late outcomes. The early outcomes included incontinence, surgical-site infection, urine retention, hemorrhage, and retained catheter. The late outcomes included fistula recurrence, residual incontinence, quality of life, reproductive issues, mental health, family and social support, and financial status.
CONCLUSIONS: The treatment outcomes of
obstetrical fistula can be grouped into short-term and long-term outcomes. Although this review found adequate studies for the analysis, most study designs were poor. Stronger studies are recommended in the future to guide policy and decision-making. We would like to suggest that researchers conduct systematic reviews and meta-analyses independently for short-term and long-term outcomes.