The burden of vesico-vaginal fistula in Ile-Ife, South Western Nigeria

Akintunde Olusegun Fehintola, Olusegun O Badejoko, Adebimpe O Ijarotimi, Babatola Bakare, Funmito O Fehintola, Adebanjo B Adeyemi

Abstract


Background: Vesicovaginal fistula is a major cause of severe morbidity and potential mortality, which can result in marital disruption, rejection, and eventual destitution.

Methodology: A retrospective study of all cases of vesicovaginal fistula managed over a 30 year period between 1st January 1984 and 31st December 2013 at theObafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.

Relevant data were obtained from the case notes and analyzed for the demographics, clinical features, management and outcome using SPSS version 20.

Result: There were 213 patients with vesicovaginal fistula over the period of the study with aprevalence of3.9 per 1000 deliveries. The age range was 15-45 years with a mean age of 24.8 years. Most of them were primiparous, (52.1%) and of the low social class (84.5%). Obstetric fistula accounted for 93.9%. The majority of them (64.8%) did not have antenatal care during the antecedent pregnancy. Labor was attended by unskilled attendants in about 90% of them while 92% labored for at least 24hours. The juxta-cervical fistula was the most common anatomical type (47.0%). The overall success rate at repair was 76.4%. Stillbirth rate in the antecedent pregnancy was 67.5%. Other associated morbidities included chronic vulva excoriation, obstetric palsy, and secondary amenorrhea.

Conclusion:Vesicovaginal fistula (VVF) is a major public health problem in developing countries with too many calamities as shown in this study. Improving the educational and economic status of women in Nigeria will go a long way in empowering them to access quality antenatal care. This will also enhance hospital delivery thereby preventing prolonged obstructed labor which is a strong etiological factor for VVF. Decentralization of treatment centers and training of specialists in fistula surgery is very important to improving treatment outcomes.


Keywords


Burden, Obstructed labour, Vesicovaginal fistula,

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DOI: http://dx.doi.org/10.24125/sanamed.v12i2.182

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