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

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Abstract

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.

Methods

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.

Results

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.

Conclusions

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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Acknowledgements

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.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics & Gynecology, NorthShore University HealthSystem, 2650 Ridge Avenue Walgreen Building, Suite 1507, Evanston, IL, USA

    Carolyn V. Kirschner

  2. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    Kathleen J. Yost

  3. Center for Clinical Research Informatics (CCRI), NorthShore University HealthSystem, Evanston, IL, USA

    Hongyan Du

  4. Department of Obstetrics & Gynecology, University of Jos, Jos, Plateau State, Nigeria

    Jonathan A. Karshima

  5. Fistula Consultants, LLP, Gallup, NM, USA

    Steven D. Arrowsmith

  6. Department of Obstetrics & Gynecology, Washington University, St. Louis, MO, USA

    L. Lewis Wall

  7. Department of Anthropology, Washington University, St. Louis, MO, USA

    L. Lewis Wall

  8. ECWA Evangel Hospital, Jos, Nigeria

    Carolyn V. Kirschner

Authors
  1. Carolyn V. Kirschner
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  2. Kathleen J. Yost
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  3. Hongyan Du
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  4. Jonathan A. Karshima
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  5. Steven D. Arrowsmith
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  6. L. Lewis Wall
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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). https://doi.org/10.1007/s00192-010-1231-0

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  • DOI: https://doi.org/10.1007/s00192-010-1231-0

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