Management of Vesicovaginal Fistulae
| Autor: | Rachel N. Pauls, Monica L. Richardson, Fiona M. Lindo, K.A. Greene, Ladin A. Yurteri-Kaplan, Nicole M. Book, Cynthia S. Fok, Cristina M. Saiz, Amos Adelowo, Heidi W. Brown, Joy A. Greer, Susan H. Oakley, Heidi S. Harvie, Leon N. Plowright |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Urology Treatment outcome Article symbols.namesake Gynecologic Surgical Procedures Risk Factors Catheter drainage medicine Humans Surgical treatment Fisher's exact test Aged Retrospective Studies Vesicovaginal Fistula business.industry General surgery Obstetrics and Gynecology Mean age Odds ratio Middle Aged United States Treatment Outcome Multicenter study symbols Female Surgery business Body mass index |
| Zdroj: | Female Pelvic Medicine & Reconstructive Surgery. 20:7-13 |
| ISSN: | 2151-8378 |
| Popis: | OBJECTIVES Vesicovaginal fistulae (VVF) are the most commonly acquired fistulae of the urinary tract, but we lack a standardized algorithm for their management. The purpose of this multicenter study was to describe practice patterns and treatment outcomes of VVF in the United States. METHODS This institutional review board-approved multicenter review included 12 academic centers. Cases were identified using International Classification of Diseases codes for VVF from July 2006 through June 2011. Data collected included demographics, VVF type (simple or complex), location and size, management, and postoperative outcomes. χ(2), Fisher exact, and Student t tests, and odds ratios were used to compare VVF management strategies and treatment outcomes. RESULTS Two hundred twenty-six subjects were included. The mean age was 50 (14) years; mean body mass index was 29 (8) kg/m(2). Most were postmenopausal (53.0%), nonsmokers (59.5%), and white (71.4%). Benign gynecologic surgery was the cause for most VVF (76.2%). Most of VVF identified were simple (77.0%). Sixty (26.5%) VVF were initially managed conservatively with catheter drainage, of which 11.7% (7/60) resolved. Of the 166 VVF initially managed surgically, 77.5% resolved. In all, 219 subjects underwent surgical treatment and 83.1% of these were cured. CONCLUSIONS Most of VVF in this series was managed initially with surgery, with a 77.5% success rate. Of those treated conservatively, only 11.7% resolved. Surgery should be considered as the preferred approach to treat primary VVF. |
| Databáze: | OpenAIRE |
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