International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023
Surgical repair of post-cesarean vesicouterine fistula: A systematic review and a plea for prevention.
Систематический обзорСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bonavina Giulia, Busnelli Andrea, Acerboni Stefano, Martini Alberto, Candiani Massimo, Bulfoni Alessandro
Аннотация
BACKGROUND: Vesicouterine fistula (VUF) is a iatrogenic injury in the vast majority of cases. The worldwide increase of cesarean delivery rates is expected to lead to increased complications.
OBJECTIVES: To assess current evidence on VUF pathogenesis and surgical management.
SEARCH STRATEGY: Pubmed and Embase databases were searched from January 2000 to January 2023 using relevant key words.
SELECTION CRITERIA: Only original articles including either transabdominal or transvaginal surgical routes for post-cesarean VUF repair, in English language, were included.
DATA COLLECTION AND ANALYSIS: Two authors independently screened the references for eligibility, data extraction, and assessment of methodologic quality. All available surgical outcomes were recorded.
MAIN RESULTS: Of the 1160 studies retrieved, 67 were selected for analysis. Most of these were case reports, case series, or observational cohort studies including a total of 284 patients. The majority (78.6%) of patients had more than one cesarean section, and approximately 10% of them experienced an overt bladder injury and/or uterine rupture at the time of cesarean delivery. The supratrigonal part of the bladder was most commonly involved (92.5%). The majority of patients (88.8%) underwent delayed VUF repair through laparotomy. Length of stay and blood loss were significantly less in patients treated via a minimally invasive approach (P < 0.001 and P = 0.02, respectively). Most patients had double-layer bladder repair and single-layer uterine repair. The overall success rate was 100% on first attempt for each independent combination of different surgical approaches and techniques. Live birth following VUF repair was reported in 23 patients.
CONCLUSIONS: Paying close attention to surgical details is crucial to reduce the incidence of this complication and recurrence rates. Double-layer bladder closure and delayed timing of repair of VUF are recommended.
OBJECTIVES: To assess current evidence on VUF pathogenesis and surgical management.
SEARCH STRATEGY: Pubmed and Embase databases were searched from January 2000 to January 2023 using relevant key words.
SELECTION CRITERIA: Only original articles including either transabdominal or transvaginal surgical routes for post-cesarean VUF repair, in English language, were included.
DATA COLLECTION AND ANALYSIS: Two authors independently screened the references for eligibility, data extraction, and assessment of methodologic quality. All available surgical outcomes were recorded.
MAIN RESULTS: Of the 1160 studies retrieved, 67 were selected for analysis. Most of these were case reports, case series, or observational cohort studies including a total of 284 patients. The majority (78.6%) of patients had more than one cesarean section, and approximately 10% of them experienced an overt bladder injury and/or uterine rupture at the time of cesarean delivery. The supratrigonal part of the bladder was most commonly involved (92.5%). The majority of patients (88.8%) underwent delayed VUF repair through laparotomy. Length of stay and blood loss were significantly less in patients treated via a minimally invasive approach (P < 0.001 and P = 0.02, respectively). Most patients had double-layer bladder repair and single-layer uterine repair. The overall success rate was 100% on first attempt for each independent combination of different surgical approaches and techniques. Live birth following VUF repair was reported in 23 patients.
CONCLUSIONS: Paying close attention to surgical details is crucial to reduce the incidence of this complication and recurrence rates. Double-layer bladder closure and delayed timing of repair of VUF are recommended.