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


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.


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.


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.


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.


Colovaginal fistula Hospital discharge data Rectovaginal fistula Surgical repair Vesicovaginal fistula 



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

Conflicts of interest



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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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