Sexual violence-related fistulas in the Democratic Republic of Congo
Onsrud, M.; Sjøveian, S.ør.; Luhiriri, R.; Mukwege, D.
International Journal of Gynaecology and Obstetrics the Official Organ of the International Federation of Gynaecology and Obstetrics 103(3): 265-269
2008
ISSN/ISBN: 0020-7292 PMID: 18812246 DOI: 10.1016/j.ijgo.2008.07.018Document Number: 202560
To determine the magnitude of traumatic gynecologic fistulas caused by sexual violence in the Democratic Republic of Congo. A retrospective analysis of hospital records from 604 consecutive patients who received treatment for gynecologic fistulas at Panzi Hospital between November 2005 and November 2007. Of the 604 patients, 24 (4%) reported that their fistulas had been caused by sexual violence; of these, 5 (0.8%) had developed fistulas as a direct result of forced penetration with foreign objects and/or gang rapes. Of the remaining patients, 6 had a fistula before they were raped, 9 developed iatrogenic fistulas following inappropriate instrumentation to manage rape-induced spontaneous abortion or stillbirth, or after abdominal hysterectomy, and 4 developed fistulas after prolonged and obstructed labor. Traumatic fistulas are rare compared to obstetric fistulas. Fistulas indirectly related to sexual violence are likely to be more common than those directly related. All fistulas resulting from sexual violence, whether direct or indirect, should be considered traumatic and special care should be given to these women.