Profile and outcome of patients with recurrent urogenital fistula in a fistula centre in Nigeria
Introduction and hypothesis
Management of a recurrent urogenital fistula is very challenging and requires experienced surgeons. The aim of this study was to describe the characteristics, success rates, and associated factors related to surgical repairs of patients with recurrent urogenital fistulas by an experienced team at a fistula centre in Nigeria.
This was a retrospective cohort study of 154 patients that had repeat urogenital fistula repairs at the National Obstetric Fistula Centre, Abakaliki, Nigeria, between January 2014 and December 2016. Information was retrieved from their hospital records. Successful repair was defined by continent status at 3 months after repair. Data were analyzed with SPSS version 20 by IBM Inc., and p < 0.05 was taken as statistically significant. Chi-square test was used to determine the association between the factors and successful repair.
The mean age was 36.27 ± 12.96 years. Obstetric fistula occurred in 92.2% of the patients. The success rates for the first, second, third, and fourth repeat repairs were 68.8%. 56.2%, 50%, and 0% respectively. Significant factors were the number of previous attempts at repair (χ2 = 20.44, p = 0.002), age group (χ2 = 16.95, p = 0.03), Waaldijk’s classification (χ2 = 13.31, p = 0.04), duration of fistula (χ2 = 19.6, p = 0.03), surgeons’ experience (χ2 = 7.11, p = 0.04), and place of previous attempt at repair (χ2 = 6.35, p = 0.02). There were no complications in 86.4%.
The success rate was good. Patients who had previous failed repairs at the fistula centre had better outcomes after the repeat surgeries. Centralizing fistula care will enhance optimal outcomes. It may also boost training and research in this specialty.
KeywordsUrogenital fistula Continence Success rate Previous failed repair
The authors appreciate Mrs. Marcelina who helped to retrieve the patients’ records.
Compliance with ethical standards
Conflicts of interest
- 2.Williams S. Vesicovaginal fistula. BJUI. 1999;83(5):564–70.Google Scholar
- 8.Qadir T, Ghaffar N, Baloch SN, Muneer A. Clinical pattern and outcome of vesicovaginal fistula. JRMC. 2014;18(2):270–3.Google Scholar
- 13.Tebeu PM. Fosso GK, Vadandi V, Dobit JS, Fomulu JN, Rochat CH (2013) Prognostic value of repeated surgery on obstetric Vesicovaginal fistula outcome: a Cameroonian experience. Asian Pacific J Reprod 330–332.Google Scholar
- 18.Inimgba NM, Okpani AOU, John CT. Vesico-vaginal fistulae in Port Harcourt, Nigeria. Trop J Obstet Gynaecol. 1999;16:49–51.Google Scholar
- 19.Odusoga OL, Oloyede OAO, Fakoya TA, Sule-Odu AO. Obstetric vesico-vaginal fistula in Sagamu. Nig Med Pract. 2001;39:73–5.Google Scholar