Epidemiologic study of vesicovaginal fistulas in ethiopia
Kelly, J.; Kwast, B.E.
International Urogynecology Journal 4(5): 278-281
1993
ISSN/ISBN: 0937-3462 DOI: 10.1007/bf00372737Document Number: 341102
Three hundred and nine patients (a 1∶10 random sample) treated at the Addis Ababa Fistula Hospital during the years 1983 to 1988 were studied for biosocial factors, obstetric history, previous attempts at repair, the condition of the patient and the extent of injury to the genitourinary tract, as well as treatment and results. Sixty-five percent of patients were under 25 years. The cause of the fistula was obstructed labor in 97.4%; in 62.7% it was the patient's first labor; the outcome for the baby was a stillbirth in 92.7%. The fistula was complicated in 69.4%; a Martius graft was used in 73.6%; 88% were cured; 5.8% of repairs failed and in 6.2% the patient had stress incontinence. Obstetric fistulas in Ethiopia result from obstructed labor, mostly in a first pregnancy in young women, and it is rare for the baby to survive. Prevention will involve improved education, communication, transport and health care measures. With good preoperative and postoperative care and attention to surgical detail many of these women can be cured.