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Tropical Journal of Obstetrics and Gynaecology

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Epidemiology of Vesico-Vaginal Fistula at the University of Ilorin Teaching Hospital, Ilorin, Nigeria

Munir-deen A. Ijaiya, Abiodun P. Aboyeji, Zainab B.B. Ijaiya

Abstract


Context: Vesico-vaginal fistula (VVF) is a major public health problem in Nigeria.


Objective: To describe the causes and patterns of presentation of vesico-vaginal fistula in a tertiary hospital in Central Nigeria.


Subjects and Methodology: Records of all patients with VVF seen over a 10-year period (1st January, 1988 to 31st December, 1997) at the University of Ilorin Teaching Hospital were reviewed. The patients' social and demographic data, aetiological factors, anatomical types and complications of VVF were analysed.


Results: There were 44 cases of VVF during the period. Obstetric VVF accounted for 37 (84.1%) of the cases. Most of the patients were illiterate 39 (88.6%), and of low social class 37 (84.1%). Most had poorly supervised deliveries; 33 (89.2%). The age of the patients ranged between 15 and 73 years with a mean age of 29.4 years. The highest frequency was in the 15-19 years age bracket (25%) and 43.2% were primiparous women. Prolonged obstructed labour (65.9%) was the commonest cause of VVF in the patients. Other causes include advanced cervical cancer 6 (13.6%), ruptured uterus 3 (6.8%), caesarean section 3 (6.8%), forceps delivery 1 (2.3%), caesarean hysterectomy 1 (2.3%) and total abdominal hysterectomy 1 (2.3%). Twelve (27.3%) patients were separated/divorced from their husbands. Of the 33 VVF patients that had VVF repair, 29(87.9%) were successful; 27 (81.8%) at the first attempt and 2 (6.1%) at the second attempt.


Conclusion: Urinary fistulae are still a major health problem for women in this locality and prolonged obstructed labour is the major cause.


Key Words: Vesico-Vaginal Fistula, Obstructed Labour, Urinary Incontinence


[Trop J Obstet Gynaecol, 2002, 19: 101-103]



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