The Management of Vesico-vaginal Fistula in State Specialist Hospital Maiduguri, Borno State

Abstract

Background: Vesico-vaginal fistula is a common problem that has public health significance. Aims: To determine the epidemiology, causes as well as the outcomes of VVF repair in the Department of Obstetrics and Gynaecology State Specialist Hospital Maiduguri, Borno State of Nigeria. Methods: A ten year (Jan 1998 to Dec 2007) retrospective review of the patients’ records, operation theatre records and Gynaecological clinic records of patients with vesico-vaginal fistula. Results: Three hundred and eighty five (385) VVF repair were done out of 2105 gynaecological operations during the study period, giving a prevalence of 18.3%. Three hundred and forty seven (347) patients records were analysed. Most (51.9%) of the fistulae occurred in women aged 15-24 years. The patients are mostly married (79%), primiparas (56.5%), uneducated (89%) and not salaried employed (99.4%). Obstetrics complication was the commonest cause of VVF. The overall success rate of repair was 59.1%. Success of repair decreases as the number of fistula or complexity of fistula increases (p<0.0001). Conclusion: Vesico-vaginal fistula is mainly caused by prolonged obstructed labour. Complexity of fistula was associated with poor surgical outcome. Interventions that will improve access to trained delivery attendant will minimise the occurrence of prolonged obstructed labour and that will go a long way to decrease the incidence of vesico-vaginal fistula.