Abstract
The objective of our study was to report on the epidemiological and etiopathogenic aspects of obstetric fistulas and to evaluate the results of their management at the National Fistula Treatment Centre in N'Djamena (Chad). Patients and Methods: This was a retrospective, descriptive study conducted at the National Fistula Treatment Centre in N'Djamena over a 4-year period from January 2012 to December 2016. Results: The mean age of our patients was 26.38 years with extremes of 12 to 74 years. The majority of our patients were young women aged 12 to 22 years. Of the patients 82.5% resided in rural areas. They were housewives in 88.9% and victims of genital mutilation in 76.8%. 73.6% did not have a prenatal consultation. A vaginal delivery was recorded in 74.9%. Perinatal infant mortality was recorded in 83.2%. Spinal anaesthesia was used in 95.7% of cases. The repair by low way in 93.7%. The success rate in a so-called first-hand fistulas was noted in 88.88%. Conclusion: Obstetrical fistulas is a real public health problem in our countries. Women with fistula are victims of all forms of social exclusion. The most effective means of combating it remains prevention and access to emergency obstetric care.
Highlights
Obstetrical fistula is an abnormal acquired communication between the urinary and genital tracts or between the genital tract and digestive system
Vesico-vaginal fistula cases rarely do exist in the Western World while they are very common in developing Countries of Africa, Asia and South America
The goal of this article was to report our experience treating the obstetrical fistula at the National Fistula Treatment Center in N'Djamena (Chad) and to analyze it’s epidemiogical, etiological and therapeutical aspects in order to promote a better treatment
Summary
Obstetrical fistula is an abnormal acquired communication between the urinary and genital tracts or between the genital tract and digestive system. Vesico-vaginal fistula cases rarely do exist in the Western World while they are very common in developing Countries of Africa, Asia and South America. Vesico-vaginal fistula is the main public health challenge in the African continent. The World Health Organization (WHO) estimates up to 2 to 3.5 millions women survivors of the obstetric fistula only in Africa [4]. It acts as a barometer on inequality accessing maternal health care in poor countries. We have registered a success rate of 75.55% (n=327) in simple fistula cases
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