Abstract
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.
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Abbo AH. New trends in the operative management of urinary fistulae. Sudan Med J 1975;13:126–132
Barnaud PL, Veillard JM, Richard J et al. Les fistulas vesico-vaginales Africaines. Med Trop 1980;40:389–401
Tahzib F. Epidemiological determinants of vesico-vaginal fistulae. Br J Obstet Gynaecol 1983;90:387–391
Hamlin RJ, Nicholson EC. Experiences in the treatment of 600 vaginal fistulas and in the management of 80 labors which have followed the repair of these injuries. Ethiopian Med J 1966;4:189–192
Kelly J. Vesico-vaginal fistulae. Br J Urol 1979;51:208–210
Kelly J. Vesico-vaginal fistulae. In: Studd J, ed. Progress in obstetrics and gynaecology. Edinburgh: Churchill Livingstone, 1983;324–333
Martius H. Vesico-genital and urethro-genital fistulas. In: Martius H, Newman Dorland WA, eds. Gynecologic operations and their topographic-anatomic fundamentals. Chicago: Debour, 1939;353–399
Hamlin RJ, Nicholson EC. Reconstruction of urethra totally destroyed in labor. Br Med J 1969;4:147–150
Attat Hospital Annual Reports (1986–1990). Attat Hospital, Gurage, Southern Shoa, Ethiopia
Poovan P, Kifle F, Kwast BE. A maternity waiting home reduces obstetric catastrophes. World Health Forum 1990;ii:440–445
Kelly I. Vesico-vaginal fistulae. Lancet 1989;ii:109
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Kelly, J., Kwast, B.E. Epidemiologic study of vesicovaginal fistulas in ethiopia. Int Urogynecol J 4, 278–281 (1993). https://doi.org/10.1007/BF00372737
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DOI: https://doi.org/10.1007/BF00372737