After the repair: Voices of Vesico Vaginal Fistula (VVF) patients in southeast Nigeria.

Abstract

Background: Patients’ perception of the aetiopathogenesis of VVF is important in preventing recurrence of the fistula. Objective: To assess patients’ knowledge of the causes of the fistula and their attitude towards future pregnancy. Materials and methods: Cross sectional descriptive study using Interviewer-administered semi structured questionnaire on VVF patients between 2008 and 2010 at the Southeast fistula centre Abakaliki. A focus group discussion was held with the nurses in charge of the patients in the ward who educate the patients of the precaution needed to prevent future occurrences.
Results: A total of 147 patients participated in the study. The mean age was 34.3 +11.9 years. One hundred and forty two (96.6%) of the fistulae occurred as a result of prolonged obstructed labour. One hundred and thirty two of those with obstructed labour identified the cause of their fistula correctly. Other causes as perceived by the patient include; instrumental delivery, caesarean section, incorrect delivery method. God’s will and witchcraft were among the background factors identified as leading to the fistula. Sixty participants said they would want to get pregnant again, 10% of them were indifferent while 20% were apprehensive about the next pregnancy. The focused group discussion revealed a deficient pre and post operative counseling policy. Conclusion: A number of VVF patients do not correctly appreciate the aetiopathoenesis of the condition. There is need for a comprehensive counseling guideline for such patients. Training of care providers and public health education are advocated.

Key words: Perception, cause, vesicovaginal fistula, attitude