Urogenital fistulas in the Niger Delta Region of Southern Nigeria: A single center experience

Abstract

Objectives: To determine the factors that are associated with good prognosis in the management of patients with urogenital fistulas in our tertiary hospital in Port Harcourt, Nigeria. Materials and Methods: We retrospectively identified all patients managed fully for urogenital fistula at the University of Port Harcourt Teaching hospital from January 2018 to December 2022. From the case files, we collected data on age, parity, etiology and type of fistula, investigation findings, management, including perioperative findings and use of drugs, and outcome of treatment. Results: Of the six patients with urogenital fistulas managed, four had vesicovaginal fistulas. Obstetric fistulas were the most common, accounting for five fistulas. Four had surgical repairs, and two were resolved entirely following bladder catheterization. Of those who had a surgical repair, multidisciplinary management involving urologists and gynecologists via the abdominal approach was done in two patients. Two patients had transvaginal fistula repairs performed by only gynecologists (with no urologists). All primary fistula repairs were successful. Conclusion: Most of the urogenital fistulas in this study had obstetric origins. The patients had delayed presentation for treatment. Good patient selection with individualization of patient treatment, adequate history-taking, basic evaluation under anesthesia with three swab testing, experience, and good surgical skills as well as optimal post-treatment care were vital for a good prognosis of fistula repairs