K Waaldijk1. 1. Laure Fistula Center, Murtala Muhammad Specialist Hospital, Kano, Nigeria.
Abstract
OBJECTIVE: To develop a surgical classification for obstetric fistulas in order to compare surgical techniques and results. METHODS: Based on a retrospective analysis of 775 consecutive fistula patients, the following classification is presented: (type I) fistulas not involving the urethral closing mechanism; (type II) fistulas involving the urethral closing mechanism; and (type III) ureter and other exceptional fistulas. Type II fistulas can be further divided into: (A) without (sub)total urethra involvement, and (B) with (sub)total urethra involvement; and (a) without a circumferential defect, and (b) with a circumferential defect. This classification was applied prospectively in over 2700 consecutive fistula patients. RESULTS: The surgical technique becomes progressively more complicated from type I through type IIBb. The results of closure and continence worsen progressively from type I through type IIBb. Personal experience in the case of type III fistulas is very limited. CONCLUSION: This classification enables a systematic comparison of different surgical techniques and an objective evaluation of results from different centers.
OBJECTIVE: To develop a surgical classification for obstetric fistulas in order to compare surgical techniques and results. METHODS: Based on a retrospective analysis of 775 consecutive fistulapatients, the following classification is presented: (type I) fistulas not involving the urethral closing mechanism; (type II) fistulas involving the urethral closing mechanism; and (type III) ureter and other exceptional fistulas. Type II fistulas can be further divided into: (A) without (sub)total urethra involvement, and (B) with (sub)total urethra involvement; and (a) without a circumferential defect, and (b) with a circumferential defect. This classification was applied prospectively in over 2700 consecutive fistulapatients. RESULTS: The surgical technique becomes progressively more complicated from type I through type IIBb. The results of closure and continence worsen progressively from type I through type IIBb. Personal experience in the case of type III fistulas is very limited. CONCLUSION: This classification enables a systematic comparison of different surgical techniques and an objective evaluation of results from different centers.
Authors: A Bishinga; R Zachariah; S Hinderaker; K Tayler-Smith; M Khogali; J van Griensven; W van den Boogaard; M Tamura; B Christiaens; G Sinabajije Journal: Public Health Action Date: 2013-06-21
Authors: Susan H Oakley; Heidi W Brown; Joy A Greer; Monica L Richardson; Amos Adelowo; Ladin Yurteri-Kaplan; Fiona M Lindo; Kristie A Greene; Cynthia S Fok; Nicole M Book; Cristina M Saiz; Leon N Plowright; Heidi S Harvie; Rachel N Pauls Journal: Female Pelvic Med Reconstr Surg Date: 2014 Jan-Feb Impact factor: 2.091