Obstetric fistulae: a retrospective study of 1210 cases at the Addis Ababa Fistula Hospital

Abstract

The results of surgery in new patients presenting with a vesico-vaginal fistula are presented to relate the outcome to age, parity and aetiology of the fistula. Of the 1435 patients admitted to the hospital from January 1991 to December 1992, 1210 had had no previous attempt to repair the fistula and are included in the study. The data were collected from the patients records and a specially designed admission and treatment form. Of the 1210 cases analysed, the fistula was caused by obstructed labour in 96% (1160), and in the majority of these, labour was obstructed for more than 3 days. Half of the patients (598) were aged between 13 and 20 years on admission to hospital. Fifty-five per cent (649) developed a fistula during their first delivery and in 93% the fetal outcome was a still-birth. Of the operated 1210 cases, 1120 (92.6%) were successfully repaired. Five hundred and thirty patients were divorced by their husbands following development of the fistula. Illiteracy as common among the patients. Improvements in maternity services, development of communication networks and eradication of illiteracy are essential for the prevention of obstetric fistula. The role of reconstructive vaginal fistula surgery and the further training in this field is also emphasised.