Urethral catheter as an initial stage for obstetric vesicovaginal fistulae management

Abstract

Background: Medical practitioners including some specialists who do not have vesicovaginal fistulae (VVF) management experience are in the habit of operating VVF patients and this result to a little success or even to more surgical trauma. Therefore it is imperative to have a simple, feasible and acceptable initial care of VVF patients by all medical practitioners. The objective of this study was to demonstrate the role of indwelling urethral catheter in initial management of obstetric fistulae. Materials and Methods: In a period of 1 year (July 2009-June 2010) seven patients with obstetric fistula were evaluated prospectively and divided into two groups. Group 1 (GP1) includes five patients (71.0%) who had indwelling urethral catheter as a mainstay for their management. Group 2 consists of two patients (29.0%) who had VVF repair via vaginal approach. Demographic information, types of VVF, healing success, associated obstetric injuries, and complications were analyzed. Results: The patients' age ranged from 14 years to 18 years with average of 16.30 years. Four patients out of the seven were booked at antenatal clinic; only two out of the former had delivered at a hospital. All babies were delivered at term with male to female ratio of 2.5:1. Four patients (57.10%) had eclampsia. Five patients (71.40%) had assisted deliveries while 2 (28.60%) had cesarean section because of prolong labor. Patients started leaking urine at average 10.40 (8-14) days after delivery. Urethral catheterization was enough to heal the fistula in 5 (71.40%) patients.Conclusion: Urethral catheterization is feasible and acceptable as an initial stage for obstetric VVF management, especially in poor resource communities.