Prognostic value of repeated surgery on obstetric vesico-vaginal fistula outcome: A Cameroonian experience

Abstract

To analyze the outcome of repeat repair of vesico-vaginal fistula following a failure. This was a cross-sectional analytic study in two different obstetric fistula surgery units at the Regional Hospital of Maroua-Cameroon and the University Teaching Hospital of Yaoundé-Cameroon. The study period covered from January 2005 to December 2007 for the regional Hospital and from January 2008 to December 2011 for the University Teaching Hospital. During these periods, the first author was medical consultant in these institutions. Among the overall 81 operations analyzed, we had 31 repeat operations and 50 operations at first attempt. The chi -square test was used to compare the distribution of the various variables in the two study populations. Among the overall 81 operations analyzed, we had 31 repeat operations (37%) and 50 operations (63%) at first attempt. The success rates of closure of the fistula deteriorate with the number of attempts and vary from 88.2% at the first attempt, 76.9% at the second attempt, to 64.7% as from the third attempt. The result in terms of closing with continence also varies with the order of attempt with respective rates of 72.5%, 69.2% and 41.1% at the first, second and third attempts. The result in terms of closing with continence of obstetric fistula surgery decreases with the number of surgical attempts.