International Urogynecology Journal

, Volume 23, Issue 4, pp 403–410 | Cite as

Lower reproductive tract fistula repairs in inpatient US women, 1979–2006

  • Heidi W. Brown
  • Li Wang
  • Clareann H. Bunker
  • Jerry L. Lowder
Original Article

Abstract

Introduction and hypothesis

The objective of the study was to characterize trends in lower reproductive tract fistula (LRTF) repair in inpatient US women from 1979 to 2006.

Methods

Retrospective data was obtained from the National Hospital Discharge Survey regarding LRTF diagnoses, demographics, comorbidities, and fistula repair procedures, using ICD-9-CM diagnostic and procedure codes. Age-adjusted rates (AARs) were calculated using 1990 census data. Trends in LRTF surgical repair were evaluated using regression analysis.

Results

Between 1979 and 2006, the AAR of LRTF repair declined from 7.8 to 4.8 per 100,000 women (b = −2.97, p < 0.001). The most common surgical fistula repairs were rectovaginal, vesicovaginal, and colovaginal. The AARs of colovaginal and vesicovaginal fistula repair remained stable, while the AAR of rectovaginal fistula repair declined.

Conclusions

The AAR of inpatient LRTF repair declined between 1979 and 2006, perhaps reflecting a concurrent decrease in obstetric trauma, in the context of decreasing episiotomy and operative vaginal delivery and increasing cesarean section rates.

Keywords

Colovaginal fistula Hospital discharge data Rectovaginal fistula Surgical repair Vesicovaginal fistula 

Notes

Acknowledgments

This publication was made possible by Grant Number UL1 RR024153 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at http://www.ncrr.nih.gov/.

Conflicts of interest

None.

References

  1. 1.
    Aronson MP, Lee RA (2008) Anal incontinence and rectovaginal fistulas. In: Rock JA, Jones HW (eds) Te Linde’s operative gynecology. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, pp 994–1030Google Scholar
  2. 2.
    Meeks GR, Roth TM (2008) Vesicovaginal and urethrovaginal fistulas. In: Rock JA, Jones HW (eds) Te Linde’s operative gynecology. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, pp 973–994Google Scholar
  3. 3.
    Singhal SR, Nanda S, Singhal SK (2007) Sexual intercourse: an unusual cause of rectovaginal fistula. Eur J Obstet Gynecol Reprod Biol 131:243–244PubMedCrossRefGoogle Scholar
  4. 4.
    Arias BE, Ridgeway B, Barber MD (2008) Complications of neglected vaginal pessaries: case presentation and literature review. Int Urogynecol J Pelvic Floor Dysfunct 19:1173–1178PubMedCrossRefGoogle Scholar
  5. 5.
    Champagne BJ, McGee MF (2010) Rectovaginal fistula. Surg Clin North Am 90:69–82PubMedCrossRefGoogle Scholar
  6. 6.
    Zambon JP, Batezini NS, Pinto ER, Skaff M, Girotti ME, Almeida FG (2010) Do we need new surgical techniques to repair vesicovaginal fistulas? Int Urogynecol J Pelvic Floor Dysfunct 21:337–342CrossRefGoogle Scholar
  7. 7.
    Angioli R, Gomez-Marin O, Cantuaria G, O’Sullivan MJ (2000) Severe perineal lacerations during vaginal delivery: the University of Miami experience. Am J Obstet Gynecol 182:1083–1085PubMedCrossRefGoogle Scholar
  8. 8.
    Frankman EA, Wang L, Bunker CH, Lowder JL (2009) Episiotomy in the United States: has anything changed? Am J Obstet Gynecol 200(573):e1–e7PubMedGoogle Scholar
  9. 9.
    CDC 2010 National Hospital Discharge Survey homepage: CDC, National Center for Health Statistics.Google Scholar
  10. 10.
    Dennison C, Pokras R (2000) Design and operation of the national hospital discharge survey: 1988 redesign. Vital Health Stat 1:1–42Google Scholar
  11. 11.
    DeFrances CJ, Lucas CA, Buie VC, Golosinskiy A (2008) 2006 national hospital discharge survey. Natl Health Stat Report 1–20Google Scholar
  12. 12.
    Mangano DT (1990) Perioperative cardiac morbidity. Anesthesiology 72:153–184PubMedCrossRefGoogle Scholar
  13. 13.
    Bahadursingh AM, Longo WE (2003) Colovaginal fistulas: etiology and management. J Reprod Med 48:489–495PubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2012

Authors and Affiliations

  • Heidi W. Brown
    • 1
    • 3
  • Li Wang
    • 2
  • Clareann H. Bunker
    • 2
  • Jerry L. Lowder
    • 1
  1. 1.Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens HospitalUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Office of Clinical ResearchUniversity of Pittsburgh Clinical and Translational Science Institute (CTSI)PittsburghUSA
  3. 3.Female Pelvic Medicine & Reconstructive SurgeryUCSD Women’s Pelvic Medicine CenterLa JollaUSA

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