Skip to main content
Erschienen in: International Urogynecology Journal 12/2010

01.12.2010 | Original Article

Obstetric fistula: the ECWA Evangel VVF Center surgical experience from Jos, Nigeria

verfasst von: Carolyn V. Kirschner, Kathleen J. Yost, Hongyan Du, Jonathan A. Karshima, Steven D. Arrowsmith, L. Lewis Wall

Erschienen in: International Urogynecology Journal | Ausgabe 12/2010

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

The objectives of this study are to analyze the surgical outcomes of women undergoing obstetric fistula repair operations at the ECWA Evangel VVF Center, Jos, Nigeria, and to identify factors associated with postoperative urinary continence.

Methods

Sociodemographic and clinical data were abstracted retrospectively from the Center’s database for patients who underwent vesicovaginal fistula (VVF) repair operations. These data were compared with clinical outcome (“wet” or “dry”) at the time of hospital discharge.

Results

From August 1998 to April 2004, 1,084 fistula repair operations were performed on 926 patients. A vaginal approach was used in 90.1% of cases, and postsurgical continence was achieved in 70.5% of patients. Continence was more likely in patients with an intact urethra, an upper or midvaginal fistula, and less fibrosis than in those patients who remained wet.

Conclusions

Two thirds of patients with obstetric fistulas can be cured, with complete restoration of continence and low surgical morbidity, using a transvaginal surgical approach.
Literatur
1.
Zurück zum Zitat Tahzib F (1983) Epidemiological determinants of vesicovaginal fistulas. Br J Obstet Gynaecol 90:387–391PubMed Tahzib F (1983) Epidemiological determinants of vesicovaginal fistulas. Br J Obstet Gynaecol 90:387–391PubMed
2.
Zurück zum Zitat Wall LL (1998) Dead mothers and injured wives: the social context of maternal morbidity and mortality among the Hausa of northern Nigeria. Stud Fam Planning 29:341–359CrossRef Wall LL (1998) Dead mothers and injured wives: the social context of maternal morbidity and mortality among the Hausa of northern Nigeria. Stud Fam Planning 29:341–359CrossRef
3.
Zurück zum Zitat Tukur J, Jido TA, Uzoho CC (2006) The contribution of gishiri cut to vesicovaginal fistula in Birnin Kudu, northern Nigeria. Af J Urol 12:121–125 Tukur J, Jido TA, Uzoho CC (2006) The contribution of gishiri cut to vesicovaginal fistula in Birnin Kudu, northern Nigeria. Af J Urol 12:121–125
4.
Zurück zum Zitat Thaddeus S, Maine D (1994) Too far to walk: maternal mortality in context. Soc Sci Med 38:1091–1110CrossRefPubMed Thaddeus S, Maine D (1994) Too far to walk: maternal mortality in context. Soc Sci Med 38:1091–1110CrossRefPubMed
5.
Zurück zum Zitat Prevention of Maternal Mortality Network (1995) Situation analyses of emergency obstetric care: examples from eleven operations research projects in West Africa. Soc Sci Med 40(5):657–667CrossRef Prevention of Maternal Mortality Network (1995) Situation analyses of emergency obstetric care: examples from eleven operations research projects in West Africa. Soc Sci Med 40(5):657–667CrossRef
6.
Zurück zum Zitat The Prevention of Maternal Mortality Network (1992) Barriers to treatment of obstetric emergencies in rural communities of West Africa. Stud Fam Plann 23:279–291CrossRef The Prevention of Maternal Mortality Network (1992) Barriers to treatment of obstetric emergencies in rural communities of West Africa. Stud Fam Plann 23:279–291CrossRef
7.
Zurück zum Zitat Arrowsmith SD (1994) Genitourinary reconstruction in obstetric fistulas. J Urol 152:403–406PubMed Arrowsmith SD (1994) Genitourinary reconstruction in obstetric fistulas. J Urol 152:403–406PubMed
8.
Zurück zum Zitat Wall LL, Karshima JA, Kirschner C, Arrowsmith SD (2004) The obstetric vesicovaginal fistula: characteristics of 899 patients from Jos, Nigeria. Am J Obstet Gynecol 190:1011–1019CrossRefPubMed Wall LL, Karshima JA, Kirschner C, Arrowsmith SD (2004) The obstetric vesicovaginal fistula: characteristics of 899 patients from Jos, Nigeria. Am J Obstet Gynecol 190:1011–1019CrossRefPubMed
9.
Zurück zum Zitat Wall LL, Arrowsmith SD (2007) The “continence gap”: a critical concept in obstetric fistula repair. Int Urogynecol J 18:843–844CrossRef Wall LL, Arrowsmith SD (2007) The “continence gap”: a critical concept in obstetric fistula repair. Int Urogynecol J 18:843–844CrossRef
10.
Zurück zum Zitat Ahmad S, Nishtar A, Hafeez GA, Khan Z (2005) Management of vesico-vaginal fistulas in women. Int J Gynaecol Obstet 88:71–75CrossRefPubMed Ahmad S, Nishtar A, Hafeez GA, Khan Z (2005) Management of vesico-vaginal fistulas in women. Int J Gynaecol Obstet 88:71–75CrossRefPubMed
11.
Zurück zum Zitat Hilton P, Ward A (1998) Epidemiological and surgical aspects of urogenital fistulae: a review of 25 years’ experience in southeast Nigeria. Int Urogynecol J 9:189–194CrossRef Hilton P, Ward A (1998) Epidemiological and surgical aspects of urogenital fistulae: a review of 25 years’ experience in southeast Nigeria. Int Urogynecol J 9:189–194CrossRef
12.
Zurück zum Zitat Hilton P (2003) Vesico-vaginal fistulas in developing countries. Int J Gynaecol Obstet 82:285–295CrossRefPubMed Hilton P (2003) Vesico-vaginal fistulas in developing countries. Int J Gynaecol Obstet 82:285–295CrossRefPubMed
13.
Zurück zum Zitat Evans DH, Madjar S, Politano VA, Bejany DE, Lynne CM, Gousse AE (2001) Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary? Urology 57:670–674CrossRefPubMed Evans DH, Madjar S, Politano VA, Bejany DE, Lynne CM, Gousse AE (2001) Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary? Urology 57:670–674CrossRefPubMed
14.
Zurück zum Zitat Rangnekar NP, Imdad Ali N, Kaul SA, Pathak HR (2000) Role of the martius procedure in the management of urinary-vaginal fistulas. J Am Coll Surg 191:259–263CrossRefPubMed Rangnekar NP, Imdad Ali N, Kaul SA, Pathak HR (2000) Role of the martius procedure in the management of urinary-vaginal fistulas. J Am Coll Surg 191:259–263CrossRefPubMed
15.
Zurück zum Zitat Browning A (2006) Lack of value of the Martius fibrofatty graft in obstetric fistula repair. Int J Gynecol Obstet 93:33–37CrossRef Browning A (2006) Lack of value of the Martius fibrofatty graft in obstetric fistula repair. Int J Gynecol Obstet 93:33–37CrossRef
Metadaten
Titel
Obstetric fistula: the ECWA Evangel VVF Center surgical experience from Jos, Nigeria
verfasst von
Carolyn V. Kirschner
Kathleen J. Yost
Hongyan Du
Jonathan A. Karshima
Steven D. Arrowsmith
L. Lewis Wall
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 12/2010
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1231-0

Weitere Artikel der Ausgabe 12/2010

International Urogynecology Journal 12/2010 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.