本研究旨在确定宫颈癌根治术后泌尿生殖道瘘及延迟识别的危险因素。该研究为回顾性分析，使用中国宫颈癌主要手术并发症（MSCCCC）数据库中2004-2016年所收集的数据。提取了社会人口学特征、临床特征和医院特征的数据。使用多元 logistic 回归分析比较泌尿生殖道瘘发展的风险，并使用 Kruskal-Wallis 检验比较瘘的识别时间的差异。本研究包括满足纳入标准的23,404名患者。在癌症中心、妇女儿童医院、一线城市设施、西南地区、ⅡA期、C1型子宫切除术、腹腔镜手术和输尿管损伤情况下，与尿道阴道瘘（UVF）的发病率有关（p<0.050）。在西南地区、膀胱损伤和腹腔镜手术下，发生阴道膀胱瘘（VVF）的可能性更大（p<0.050）。在癌症中心和高 持量医院进行手术，与识别UVF的中位数时间延长有关（p=0.016; p=0.005）。国际妇产科联合会（FIGO） II A1 - II B期延迟识别VVF（p=0.040）。手术中的尿路损伤和手术方式与 UVFs 和 VVFs 的发展有关。在癌症中心和高担量医院接受手术的患者更有可能推迟识别 UVF。FIGO II A1 - II B期患者更可能推迟识别 VVF。 © 2023. 亚洲妇科肿瘤学会、韩国妇科肿瘤学会和日本妇科肿瘤学会。

This study aimed to identify the risk factors for genitourinary fistulas and delayed fistula recognition after radical hysterectomy for cervical cancer.This study was a retrospective analysis of data collected in the Major Surgical complications of Cervical Cancer in China (MSCCCC) database from 2004-2016. Data on sociodemographic characteristics, clinical characteristics, and hospital characteristics were extracted. Differences in the odds of genitourinary fistula development were investigated with multivariate logistic regression analyses, and differences in the time to recognition of genitourinary fistula were assessed by Kruskal-Wallis test.In this study, 23,404 patients met the inclusion criteria. Surgery in a cancer center, a women's and children's hospital, a facility in a first-tier city, or southwest region, stage IIA, type C1 hysterectomy, laparoscopic surgery and ureteral injury were associated with a higher risk of ureterovaginal fistula (UVF) (p<0.050). Surgery in southwest region, bladder injury and laparoscopic surgery were associated with greater odds of vesicovaginal fistula (VVF) (p<0.050). Surgery at cancer centers and high-volume hospitals was associated with an increase in the median time to UVF recognition (p=0.016; p=0.005). International Federation of Gynecology and Obstetrics (FIGO) stage IIA1-IIB was associated with delayed recognition of VVF (p=0.040).Intraoperative urinary tract injury and surgical approach were associated with differences in the development of UVFs and VVFs. Patients who underwent surgery in cancer centers and high-volume hospitals were more likely to experience delayed recognition of UVF. Patients with FIGO stage IIA1-IIB disease were more likely to experience delayed recognition of VVF.© 2023. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.