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Obstetric fistula: the ECWA Evangel VVF Center surgical experience from Jos, Nigeria


Introduction and hypothesis

The objectives of this study are to analyze the surgical outcomes of women undergoing obstetric fistula repair operations at the ECWA Evangel VVF Center, Jos, Nigeria, and to identify factors associated with postoperative urinary continence.


Sociodemographic and clinical data were abstracted retrospectively from the Center’s database for patients who underwent vesicovaginal fistula (VVF) repair operations. These data were compared with clinical outcome (“wet” or “dry”) at the time of hospital discharge.


From August 1998 to April 2004, 1,084 fistula repair operations were performed on 926 patients. A vaginal approach was used in 90.1% of cases, and postsurgical continence was achieved in 70.5% of patients. Continence was more likely in patients with an intact urethra, an upper or midvaginal fistula, and less fibrosis than in those patients who remained wet.


Two thirds of patients with obstetric fistulas can be cured, with complete restoration of continence and low surgical morbidity, using a transvaginal surgical approach.

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The authors would like to thank Sunday Lengmang, M.D. and Andy Norman, M.D. for their surgical contributions and assistance with the database, and Marci Adams for her editing assistance.

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Corresponding author

Correspondence to Carolyn V. Kirschner.

Additional information

Portions of this manuscript have been previously presented: “Vesicovaginal Fistula: our Experience with 1084 Surgical Repairs”, International Continence Society, Christchurch, New Zealand, 29/11/2006.

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Kirschner, C.V., Yost, K.J., Du, H. et al. Obstetric fistula: the ECWA Evangel VVF Center surgical experience from Jos, Nigeria. Int Urogynecol J 21, 1525–1533 (2010).

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  • Fistula surgery
  • Obstetric fistula
  • Obstructed labor
  • Rectovaginal fistula
  • Vesicovaginal fistula