A new classification for female genital tract fistula.
نویسنده
چکیده
Neglected prolonged obstructed labour is the most common cause of genital tract fistulae worldwide. Pressure necrosis of soft pelvic tissues occurs between the impacted fetal presenting part and the bony maternal pelvis. Other obstetric reasons for genital tract fistulae include vaginal trauma and laceration from instrumental deliveries or spontaneous vaginal deliveries, from Caesarean sections, symphysiotomies and destructive procedures. It is estimated (probably an underestimation) that over 100 000 new cases of fistulae occur each year and current United Nations Population Fund (UNFPA) data indicates that currently, genital tract fistulae affect at least 2 million women world-wide. In developed countries, over 90% of genital tract fistulae occur following pelvic surgery. Urinary tract injury complicates 1% of all gynaecological procedures and Caesarean sections and the incidence of genitourinary fistula following all hysterectomies is 0.8/1000. Surgery is the mainstay of treatment for the woman with a genital tract fistula. The rate of successful closure is over 85% in experienced hands but there has been a tendency to focus on the surgical closure of the fistula as the successful outcome measure rather than function following surgery. Successful surgical closure of the defect should be called ‘anatomical closure’ rather than ‘cure’, because it is clear many women suffer from ongoing pelvic organ, sexual and psychological dysfunction.
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عنوان ژورنال:
- The Australian & New Zealand journal of obstetrics & gynaecology
دوره 44 6 شماره
صفحات -
تاریخ انتشار 2004