Urinary Incontinence Following Obstetric Fistula Surgery

Abstract

AbstractFollowing the successful closure of an obstetric fistula, urinary symptoms including urinary incontinence may remain problematic in one of five affected women. These women with post-fistula urinary incontinence should be assessed to diagnose the cause of their symptoms, with stress urinary incontinence and detrusor overactivity being most common. Treatment options include conservative therapies such as pelvic floor rehabilitation, medications and continence surgery. Surgical options for stress urinary incontinence following obstetric fistula repair have had suboptimal outcomes due to the urogenital tract scarring and loss of tissue secondary to pressure necrosis which caused the obstetric fistula. There is limited data available outlining success rates and recommended management plans for women suffering with ongoing urinary symptoms following successful fistula closure. This chapter will discuss the definitions and prevalence of urinary incontinence; assessment of women with post-fistula surgery urinary incontinence; prevalence and diagnosis of post-fistula incontinence and various treatment options for urinary incontinence arising from obstetric fistula.KeywordsObstetric fistulaUrinary incontinenceStress urinary incontinenceOveractive bladderVoiding dysfunctionPost-fistula incontinence