Genitourinary fistulas experience in a tertiary hospital in North-Western Nigeria

Abstract

Background: Genitourinary fistulas are devastating, with obstetric fistula being the most common type and a major public health problem in the developing world.Aims and Objectives: This study was designed with an aim to determine the epidemiology of genitourinary fistulas in our centre.Materials and Methods: A 5 year (1st January 2013 to 31st December 2017) retrospective review based on data extracted from the case files of patients managed for gynecological fistulas at the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, North-Western Nigeria, was conducted. A proforma was used to extract data on the research variables. Data were analyzed using IBM SPSS version 24 computer statistical software package.Results: A total of 52 patients with genitourinary fistulas were managed in the period under review. The mean age of the patients was 28.25 ± 10.0 years, and majority of them (65.4%) were aged less than 30 years. Most of them (94.2%) had no formal education, and were full-time housewives (98.1%). Majority of the fistulas (69.2%) were due to prolonged obstructed labor, and close to a quarter of fistulas (23.1%) were of iatrogenic origin. About a third of patients (32.7%) have had at least a previous fistula repair. Most of them (92.3%) had surgical repair done, and it was successful in 65.4% of cases.Conclusion: Although, the genitourinary fistulas in this study were majorly of obstetric origin, a relatively high proportion of cases were of iatrogenic origin. Government should provide universal access to timely and appropriate obstetric care, and also empower women.Asian Journal of Medical Sciences Vol.9(6) 2018 31-36

Genitourinary / Fecal Fistulae: Etiology, Types and Surgical Outcomes

“…Fistula surgery is a delicate procedure and success rate is reduced with each successive attempt. This finding is consistent with other study 22 . In literature 93% success rate of VVF is seen in patients who did not have any previous attempts of repair 26 .…”

“…Other studies showed similar findings. Vesico-vaginal fistula was the most common type among all genitourinary fistulae accounting for 64-78% in various studies 20,21,22 .In our study the second most common type was uretero-vaginal fistula accounting for 10% of all varieties. Similar incidence was found in other study 20 .Priyadarshi et al quoted the frequency of uretero-vaginal fistula as 14% 21 .…”

Impact of electronic medical records on healthcare delivery in Nigeria: A Review

“…These studies were all conducted in public secondary and tertiary hospitals with the sample population ranging from doctors and nurses to patients. The risk of bias in the studies were low risk for two studies[20,21], some concern for one study [22], and high risk for two studies[23,24]. The search details are shown in Table 1 with the summary of included studies shown in Table 2.…”

“…One study examined the impact of EMR on patient care and satisfaction [23]. The study had a cross-sectional design and was conducted among 300 patients at the Federal Medical Centre, Keffi, Niger State, with the aim of assessing patients' satisfaction with EMR implementation at the hospital's pharmacy.…”

“…Most of the published literature have been perspective papers and reviews [4][5][6], case studies describing the practical experiences of hospitals setting up EMRs [7][8][9][10], primary studies exploring the barriers hindering their adoption [1,[11][12][13][14][15] and studies leveraging EMRs for research [16][17][18][19]. Several primary studies have however assessed the impact of EMRs on patient-relevant outcomes [8,[20][21][22][23][24][25], but no reviews have synthesized the evidence from them. The magnitude or direction of the impact of EMRs on these outcomes therefore remains unclear.…”