A review of urinary fistulae in a University Teaching Hospital

Abstract

An 8-year study of urinary fistulae from 1974 to 1981 was done in the University Teaching Hospital, Lusaka, Zambia. The analysis revealed no significant decrease in the number of urinary fistulae referred to the Department of Obstetrics and Gynaecology of the University during the period. Of 61 cases reviewed, 54 were consequent to obstetrical trauma of prolonged labor and superimposed operation or instrumentation. Four fistulae occurred as a complication of gynecologic surgery, while three originated from advanced malignancy of the cervix. Operative management of fistulae is discussed. Further reorganization of rural maternity services in Zambia is suggested as a preventive measure.

Management of vesico‐vaginal fistulas in women

“…When compared with the findings of studies from Nigeria, Ethiopia, Ghana and Zambia [2,5,10,11], age and parity were both higher in our study than in the African studies. This means that women who had experienced repeated deliveries in our study had fistulas more frequently than women who had 1, 2, or even 3 deliveries.…”

Obstetric fistulae: a study of women managed at the Monze Mission Hospital, Zambia

“…However, 91.6% (251/274) of operations were the first repair attempt at Monze Mission Hospital, and 8.4% The most frequent VVF site was juxtaurethral (82/259, 31.7%), commonly associated with obstructed labour. 25 In women with a VVF, the level of scarring was slight in 66.8% (169/253) of cases and moderate or severe in 26.1% (66/253). Women with multiple previous repairs were significantly more likely to have a worse level of scarring (Spearman correlation, r = 0.211, P = 0.001).…”

“…The most frequent VVF site was juxtaurethral (82/259, 31.7%), commonly associated with obstructed labour 25 . In women with a VVF, the level of scarring was slight in 66.8% (169/253) of cases and moderate or severe in 26.1% (66/253).…”

“…Only one previous study on fistula in Zambia has been published: a series of 61 women at the University Teaching Hospital, Lusaka, in 1983. It reported one‐quarter of women were teenagers, 37.6% were primigravidas, and the cure rate was 59.1% 25 . As recommended in the 2002 United Nations Populations Fund (UNFPA) Needs Assessment, gaining a clearer picture of obstetric fistula in Zambia would be valuable as it undoubtedly presents a problem, although may not be as prevalent as in other countries 2 .…”

“…It reported one-quarter of women were teenagers, 37.6% were primigravidas, and the cure rate was 59.1%. 25 As recommended in the 2002 United Nations Populations Fund (UNFPA) Needs Assessment, gaining a clearer picture of obstetric fistula in Zambia would be valuable as it undoubtedly presents a problem, although may not be as prevalent as in other countries. 2 Although knowing morbidity rates is important, a deeper understanding of the characteristics of women with fistula is essential for targeting prevention strategies effectively.…”