Altug TUNCEL, Ertugrul Gazi OZBEY, Ozer BİRGE, Muslum YİLDİZ, Özer GUZEL, Yilmaz ASLAN

The relationship between urogenital fistula and female genital mutilation

Amaç: Bu çalışmada kadın genital mutilasyon (KGM) ile vezikovajinal fistül arasındaki ilişki incelenmiştir. Gereç ve Yöntem: Çalışmaya Nyala, Sudan'da vezikovajinal fistül nedeni ile Aralık 2014'te yapılan ''Fistül kampanyası'' na başvuran toplam 78 hasta dahil edildi. Öncelikle hastaların fistül ve genital mutilasyon tipleri belirlendi. Uygulanan KGM tiplerine göre hastalar, ortalama inkontinans süreleri, operasyon tipleri, komplikasyon gelişimi, fistül nüksü açısından karşılaştırıldı. Bulgular: Çalışmaya dahil edilen hastaların ortalama yaşları 25.3±6.7 yıl idi. Hastaların ortalama doğum sayısı 3.3±2.2 idi. Kadın sünnetine göre değerlendirildiğinde hastaların 41'inin tip 2 ve 37'sinin tip 3 sünnetli olduğu saptandı. Tip 2 ve tip 3 KGM hastaları operasyon tiplerine göre karşılaştırıldığında Tip 3 KGM olguların anlamlı oranda daha fazla transvezikal girişime ihtiyaç duyduğu saptanmıştır (p=0.014). Başarı oranı tip 2 KGM hasta grubu için %73.2, Tip 3 KGM hasta grubu için %78.4 ve tüm hastalar için %75.8 olarak saptandı (p=0.405) Sonuç: KGM kadın üreme sağlığı için önemli bir risk faktörüdür.Fistülün yaratmış olduğu fiziksel, sosyal ve psikolojik travmalar nedeni ile KGM çok ciddi bir halk sağlığı problemidir. KGM'nin sık uygulandığı bölgelerde KGM'nin önlenmesi açısından uyarıcı ve bilgilendirici çalışmalar yapılması önemlidir

Kadın genital mutilasyon ile ürogenital fistül arasindaki ilişki

Aim: This study investigates the relationship between vesicovaginal fistulas and types of female genital mutilation FGM. Material and Methods: The participants of this study were 78 patients, who had taken part in "the Fistula Campaign" that was carried out in Sudan in December 2014 to raise awareness about the development of vesicovaginal fistula. First, the patients were examined and their fistula and mutilation types were determined. Then, the patients were compared in terms of the type of genital mutilation they had undergone. The average length of urinary incontinence, surgery type, development of complications and recurrence of fistula were investigated according to the type of FGM. Results: The average age of the participants was 25.3±6.7 years. The average number of births was 3.3±2.2. Forty-one patients had undergone Type 2 mutilation and 37 had undergone Type 3 genital cutting. When patients from the Type II and Type III FGM groups were compared in relation to their surgery type, the latter group patients were found to need further transvesical attempt at a significant rate. (p=0.014) The rate of success for the Type II FGM group was found to be 73.2% and 78.4% for the Type III patient group. The overall rate was calculated as 75.8%(p=0.405). Conclusion: FGM is a significant risk factor for female reproductive health. FGM-related fistulas can cause physical, social and psychological traumas in women, which arises as a serious concern for public health. Therefore, it is important to organize campaigns to raise awareness about fistulas in FGM-practiced regions

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