ObjectiveTo investigate long‐term and patient‐reported outcomes, including sexual function, in women undergoing urogenital fistula (UGF) repair, addressing the lack of such data in Western countries, where fistulas often result from iatrogenic causes.Patients and MethodsWe conducted a retrospective analysis at a tertiary referral centre (2010–2023), classifying fistulas based on World Health Organisation criteria and evaluating surgical approaches, aetiology, and characteristics. Both objective (fistula closure, reintervention rates) and subjective outcomes (validated questionnaires) were assessed. A scoping review of patient‐reported outcome measures in UGF repair was also performed.ResultsThe study included 50 patients: 17 (34%) underwent transvaginal and 33 (66%) transabdominal surgery. History of hysterectomy was present in 36 patients (72%). The median (interquartile range [IQR]) operating time was 130 (88–148) min. Fistula closure was achieved in 94% of cases at a median (IQR) follow‐up of 50 (16–91) months and reached 100% after three redo fistula repairs. Seven patients (14%) underwent reinterventions for stress urinary incontinence after transvaginal repair (autologous fascial slings). Patient‐reported outcomes showed median (IQR) scores on the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ‐FLUTS) of 5 (3–7) for filling symptoms, 1 (0–2) for voiding symptoms and 4.5 (1–9) for incontinence symptoms. The median (IQR) score on the ICIQ Female Sexual Matters Associated with Lower Urinary Tract Symptoms Module (ICIQ‐FLUTSsex) was 3 (1–5). The median (IQR) ICIQ Satisfaction (ICIQ‐S) outcome score and overall satisfaction with surgery item score was 22 (18.5–23.5) and 10 (8.5–10), respectively. Higher scores indicate higher symptom burden and treatment satisfaction, respectively. Our scoping review included 1784 women, revealing mixed aetiology and methodological and aetiological heterogeneity, thus complicating cross‐study comparisons.ConclusionsUrogenital fistula repair at a specialised centre leads to excellent outcomes and high satisfaction. Patients with urethrovaginal fistulas are at increased risk of stress urinary incontinence, possibly due to the original trauma site of the fistula.

中文翻译：

---

女性非产科泌尿生殖瘘修复：患者报告的长期结果和范围文献综述

目的调查接受泌尿生殖道瘘（UGF）修复术的女性的长期和患者报告的结果，包括性功能，解决西方国家缺乏此类数据的问题，在西方国家，瘘管通常是由医源性原因引起的。患者和方法我们进行了回顾性分析在三级转诊中心（2010-2023），根据世界卫生组织的标准对瘘管进行分类并评估手术方法、病因和特征。对客观结果（瘘管闭合、再干预率）和主观结果（经过验证的问卷）进行了评估。还对患者报告的 UGF 修复结果指标进行了范围审查。结果该研究纳入了 50 名患者：17 名患者 (34%) 接受了经阴道手术，33 名患者 (66%) 接受了经腹部手术。 36 名患者 (72%) 有子宫切除史。中位手术时间（四分位距 [IQR]）为 130 (88–148) 分钟。在中位 (IQR) 50 (16-91) 个月的随访中，94% 的病例实现了瘘管闭合，并在 3 次重做瘘管修复后达到 100%。七名患者（14%）在经阴道修复（自体筋膜吊带）后因压力性尿失禁而接受了再干预。患者报告的结果显示，国际失禁咨询问卷女性下尿路症状模块 (ICIQ-FLUTS) 的中位 (IQR) 评分为：充盈症状为 5 (3-7)，排尿症状为 1 (0-2)，排尿症状为 4.5 (1-9) 针对失禁症状。 ICIQ 与下尿路症状相关的女性性问题模块 (ICIQ-FLUTSsex) 的中位 (IQR) 得分为 3 (1-5)。中位（IQR）ICIQ满意度（ICIQ-S）结果评分和手术项目评分总体满意度分别为22（18.5-23.5）和10（8.5-10）。分数越高分别表明症状负担和治疗满意度越高。我们的范围审查包括 1784 名女性，揭示了混合的病因学以及方法学和病因学异质性，从而使交叉研究比较复杂化。结论在专业中心进行泌尿生殖瘘修复可带来优异的结果和高满意度。尿道阴道瘘患者发生压力性尿失禁的风险增加，可能是由于瘘管的原始创伤部位所致。