Repair of obstetric vesicovaginal fistulas in Africa

Abstract

The purpose of this study was to show the outcomes of primary surgical repair of obstetric vesicovaginal fistula repairs in Niger, Africa. From October 2003 to April 2005, 90 patients were examined with vesicovaginal fistulas and no previous repair. Fistulas were variable in location and degree of scarring and ranged up to 7 cm in size. All patients were offered surgical repair. Primary repair was performed in 73 women. Successful primary closure was achieved in 41 patients (56%); 19 patients were lost to follow up, and 13 patients had a persistent fistula. Incontinence, despite fistula closure, was present in 9 patients. Common features of failure and/or incontinence included larger size, involvement of the urethrovesical junction, and scarring. The initial repair of vesicovaginal fistulas has the highest probability of success. The successful closure is dependent on size, site, and associated scarring.