Decreasing incidence and changing aetiological factors of vesico-vaginal fistula in south-east Nigeria

Obi, SN; Bc, Ozumba; Onyebuchi, Azubuike K.

doi:10.1080/01443610802397686

Cited by 11 publications

(9 citation statements)

References 15 publications

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“…Other studies have documented a rising incidence of VVF from other causes. 7,22 Three clients developed VVF following female genital cutting. This is a sad reminder of the negative effects of this cultural practice which needs to be completely abolished.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, profile and obstetric experience of fistula patients in Abakaliki, Southeast Nigeria

Sunday-Adeoye

Okonta

Ulu

2011

UIJ

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Objective. Fistula has always been thought to be a scourge of the Northern region of Nigeria only. This study was aimed at providing data on the prevalence, profile and obstetric experience of fistula patients in Abakaliki, Southeast Nigeria and to demonstrate that fistula is also a burden in the southern parts of Nigeria. Materials and Methods. This was a prospective descriptive study conducted between 2003 and 2009. Sample size and sampling method. Four hundred and sixty-two fistula patients who were operated at the Fistula Unit of the Teaching Hospital and later at the Southeast Fistula Centre was consecutively recruited and interviewed during the study period. Results. The prevalence of fistula was 4.3%, the mean age was 35±9.5 years and 8.4% was less than 20 years, majority of them had no formal education. A quarter had no occupation and majority had no regular monthly income. Twenty percent were married by the age of 14 years and majority were multiparous. In about 40%, the fistula occurred during the first child birth. About 34% were still sexually active and 30% of the married clients had achieved childbirth after development of fistula. The average height and weight were 1.47m±0.08 and 46.4kg±7.2 respectively. Majority had fistula following prolonged obstructed labour, though 42.6% eventually had caesarean section for prolonged obstructed labour. Majority of the patients were older, had a longer urine leakage and presented latter for corrective surgery than those reported from other parts of Nigeria. Conclusions. There is a high prevalence (43.6/1000 deliveries) of obstetric fistula in this Centre, and majority of the vesico-vaginal fistula (VVF) was due to prolonged obstructed labour. Majority of the patients were older, had a longer urine leakage and presented latter for corrective surgery than those reported from other parts of Nigeria. However, 30% of the married patients achieved a pregnancy and delivered vaginally even in the presence of the fistula

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Section: Discussionmentioning

confidence: 99%

Prevalence, profile and obstetric experience of fistula patients in Abakaliki, Southeast Nigeria

Sunday-Adeoye

Okonta

Ulu

2011

UIJ

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“…In some developing countries, substantial progress has been recorded: for example, in south-east Nigeria, the number of genital fistulas seen in one hospital fell from 136 cases in 1981 to 35 cases in 2005, possibly due to increased access to tertiary care and improved nutrition (Obi et al 2008). …”

Section: Key Neglected Maternal Morbiditiesmentioning

confidence: 99%

Maternal morbidity: Neglected dimension of safe motherhood in the developing world

Hardee

Blanc

2012

Global Public Health

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In safe motherhood programming in the developing world, insufficient attention has been given to maternal morbidity, which can extend well beyond childbirth. For every woman who dies of pregnancy-related causes, an estimated 20 women experience acute or chronic morbidity. Maternal morbidity adversely affects families, communities and societies. Maternal morbidity has multiple causes, with duration ranging from acute to chronic, severity ranging from transient to permanent and with a range of diagnosis and treatment options. This article addresses six selected relatively neglected aspects of maternal morbidity to illustrate the range of acute and chronic morbidities that can affect women related to pregnancy and childbearing that are prevalent in developing countries: anaemia, maternal depression, infertility, fistula, uterine rupture and scarring and genital and uterine prolapse. Based on this review, recommendations to reduce maternal morbidity include: expand the focus of safe motherhood to explicitly include morbidity; improve data on incidence and prevalence of maternal morbidity; link mortality and morbidity outcomes and programming; increase access to facility- and community-based maternal health care and reproductive health care; and address the antecedents to poor maternal health through a lifecycle approach.

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“…This would result in necrosis secondary to pressure of the foetal head on the vagina. However the incidence has decreased over the past 2 decades 8. Fistulas can be classified according to size, as shown in Table 1.…”

Section: Discussionmentioning

confidence: 99%

Vesico-vaginal fistula post cold cup bladder biopsy: mini review

Mawhinney

Hameed²,

Thwaini³

et al. 2010

OAJU

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IntroductionWe report a case of a vesico-vaginal fistula (VVF) post cold cup biopsy; to our knowledge this is the only reported case. We present the clinical history/presentation, investigation and the outcome of the treatment. VVFs are among the most distressing complications of gynecologic and obstetric procedures. The risk of developing a VVF is more than 1% after radical surgery and radiotherapy for malignancies. Management of these fistulas has been better defined and standardized over the last decade.Methods and resultsA case of low grade superficial bladder cancer was treated with multiple resections of bladder tumor and a single installation of mitomycin post initial resection which successfully cleared her bladder cancer, but nevertheless led to a small size and scarred bladder. In addition there was a long history of smoking with its effects on tissue integrity and healing. VVFs are very rare and are an unpleasant outcome post a cold cup biopsy, adding to the psychological and social effects of the surgical treatment.ConclusionAlthough cold cup biopsy is a normal day procedure performed by both residents and consultants, consensus should exist on how to treat a patient who has a bladder with defective integrity and small capacity. The rate of successful fistula repair reported in the literature varies between 70% and 100% in nonradiated patients, with similar results when a vaginal or abdominal approach is performed, the mean success rates being 91% and 97%, respectively.

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Decreasing incidence and changing aetiological factors of vesico-vaginal fistula in south-east Nigeria

Cited by 11 publications

References 15 publications

Prevalence, profile and obstetric experience of fistula patients in Abakaliki, Southeast Nigeria

Prevalence, profile and obstetric experience of fistula patients in Abakaliki, Southeast Nigeria

Maternal morbidity: Neglected dimension of safe motherhood in the developing world

Vesico-vaginal fistula post cold cup bladder biopsy: mini review

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