Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 14 , ISSUE 1 ( January-February, 2022 ) > List of Articles

Original Article

Outcome of Vesicovaginal Fistula Repair: An Experience at Hamlin Fistula Hospital, Ethiopia

Syed H Ala, Samia Husain

Keywords : Fistula, Urinary incontinence, Vesicovaginal fistula

Citation Information : Ala SH, Husain S. Outcome of Vesicovaginal Fistula Repair: An Experience at Hamlin Fistula Hospital, Ethiopia. J South Asian Feder Obs Gynae 2022; 14 (1):11-13.

DOI: 10.5005/jp-journals-10006-1992

License: CC BY-NC 4.0

Published Online: 13-04-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim and objective: The purpose of this study was to assess the outcomes of surgical repair of obstetric vesicovaginal fistula repairs at Hamlin Fistula Hospital, Ethiopia. Materials and methods: This is a case series study of vesicovaginal fistula repair at Hamlin fistula hospital, Addis Ababa and Hamlin Fistula Centre, Yirgalem, Ethiopia. All women were operated under spinal anesthesia. Bladder was kept empty with free drainage for 14 days. Upon removal of catheter woman was asked to pass urine and postvoid ultrasound was done. They were followed up at 6 and 12 months. The fistula was classified according to the Goh classification system. Surgical outcomes of the surgery were “Fistula closed + patient continent,” “Fistula closed + patient incontinent,” “Fistula not closed + patient incontinent.” Results: A total of 17 cases operated independently. All the fistulas were associated with complications of labor and delivery. Prolonged obstructed labor was found in all 17 women. Sixteen out of seventeen patients were dry during immediate postoperative period. Successful closure was achieved in 11 patients (65%), despite fistula closure; stress incontinence was present in 5 (35%) patients at 6 months and 1 year follow-up. However, one patient was wet on operative evening. Her left ureter was in the scar and unidentifiable during surgery. Conclusion: The successful repair depends upon site, size, duration of fistula, and degree of scarring. However, some patients remained wet after successful closure due to incontinence problems. Clinical significance: The Goh classification has good prognostic value in determining the risk of urinary incontinence after anatomical closure of vesicovaginal fistulae.

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  1. Moir JC. Vesico-vaginal fistulae as seen in Britain. BJOG 1973;80(7): 598–602. DOI: 10.1111/j.1471-0528.1973.tb16032.x.
  2. Wall LL. Obstetric vesicovaginal fistula as an international public-health problem. Lancet 2006;368(9542):1201–1209. DOI: 10.1016/S0140-6736(06)69476-2.
  3. Muleta M. Obstetric fistula in developing countries: a review article. J Obstet Gynaecol Canada 2006;28(11):962–966. DOI: 10.1016/S1701-2163(16)32305-2.
  4. Elneil S, Patel N, Rushwan H, et al. Global competency-based fistula surgery training manual. FIGO House, Suite 2011;3:119.
  5. [cited on January 20, 2019].
  6. Chassar Moir J. The vesico-vaginal fistula. 2nd ed. London: Bailliere, Tindall and Cassel; 1967. p. 8.
  7. Naru T, Rizvi JH, Talati J. Surgical repair of genital fistulae. J Obstet Gynaecol Res 2004;30(4):293–296. DOI: 10.1111/j.1447-0756.2004.00196.x.
  8. Goh JT. A new classification for female genital tract fistula. Aust N Z J Obstet Gynaecol 2004;44(6):502–504. DOI: 10.1111/j.1479-828X.2004.00315.x.
  9. Muleta M, Rasmussen S, Kiserud T. Obstetric fistula in 14,928 Ethiopian women. Acta Obstet Gynecol Scand 2010;89(7):945–951. DOI: 10.3109/00016341003801698.
  10. Muleta M. Socio-demographic profile and obstetric experience of fistula patients managed at the Addis Ababa Fistula Hospital. Ethiop Med J 2004;42(1):9–16. PMID: 15884272.
  11. Amodu OC, Salami B, Richter S. Obstetric fistula and sociocultural practices in Hausa community of Northern Nigeria. Women Birth 2017;30(5):e258–e263. DOI: 10.1016/j.wombi.2017.02.009.
  12. Andargie AA, Debu A. Determinants of obstetric fistula in Ethiopia. Afr Health Sci 2017;17(3):671–680. DOI: 10.4314/ahs.v17i3.9.
  13. Zhang WY, Hu H, Zhang XP, et al. [Comparison and discussion of different surgical methods used to treat vesicovaginal fistulas]. Beijing Da Xue Xue Bao Yi Xue Ban 2017;49(5):889–892. PMID: 29045975.
  14. Milicevic S, Krivokuca V, Ecim-Zlojutro V, et al. Treatment of vesicovaginal fistulas: an experience of 30 cases. Med Arch 2013;67(4):266–269. DOI: 10.5455/medarh.2013.67.266-269.
  15. Theofanides MC, Sui W, Sebesta EM, et al. Vesicovaginal fistulas in the developed world: an analysis of disease characteristics, treatments, and complications of surgical repair using the ACS-NSQIP database. Neurourol Urodyn 2017;36(6):1622–1628. DOI: 10.1002/nau.23167.
  16. Zhou L, Yang TX, Luo DY, et al. Factors influencing repair outcomes of vesicovaginal fistula: a retrospective review of 139 procedures. Urol Int 2017;99(1):22–28. DOI: 10.1159/000452166.
  17. Beardmore-Gray A, Pakzad M, Hamid R, et al. Does the Goh classification predict the outcome of vesico-vaginal fistula repair in the developed world? Int Urogynecol J 2017;28(6):937–940. DOI: 10.1007/s00192-016-3186-2.
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