Determinants of obstetric vesicovaginal fistula surgery at the National Reference Center for Obstetric Fistula (CNRFO)

Abstract

Vesicovaginal fistula is a major public health problem in sub-Saharan Africa in general and in Niger in particular. The objective was to study the determinants of obstetric surgery of the vesicovaginal fistula. This was a cross-sectional, analytical, retro-prospective study conducted from January 2022 to February 2024. All women with obstetric vesicovaginal fistulas who had been treated were included. The search for factors associated with surgical treatment was performed by bivariate analysis using the Pearson Chi2 test at the 5% significance level. A total of 64 patients were identified, the frequency was estimated at 22.14%. The mean age was 30.09 years. Uneducated patients accounted for 71.95%; 78.12% had a low socio-economic level and for 81.3%, the age at first marriage was between 15 and 25 years old. The causal duration of labour was ≥ 72 hours in 57.8%. The surgical treatment (fistulorrhaphy) was a success for 92.18%. The causative child was stillborn in 84.4% of cases. Withdrawal was observed in 46.66%. In the bivariate analysis, the result of surgical treatment was statistically associated with the number of interventions (p = 0.007). The fistula sufferer is a young woman, uneducated, of low socio-economic status who has lost the fruit of her pregnancy and who is socially withdrawn in our study. The reconstructive surgery performed was mostly successful. The best way to eliminate obstetric fistula is to prevent it through interventions that protect women's health. Socio-professional reintegration is necessary in order to reduce the psychosocial repercussions of this pathology. Keywords: determinants, surgery, fistulas, vesico-vaginal, obstetrics, Niger.