o r i g i n a l c o m m u n i c a t i o n
A Review of Clinical Pattern and Outcome of
Ajenifuja Kayode Olusegun, MBBS, FWACS; Adepiti C. Akinfolarin, MBChB; Loto M. Olabisi, MBChB,
tion between the bladder and the vagina. In this condition
Objectives: The aim of this study was to determine the inci-
the woman continuously leaks urine from her vagina.
dence, sociodemographic parameters, and outcome of
The condition was once prevalent in North America
surgical repairs of obstetric fistula in our center.
and Europe but has become a rarity due to improve-
Methods: Case files of patients managed for genital tract fis- ments in the general health of women and obstetric care.
tula over a 10-year period (January 1, 1997 to December 31, Fistulae in the Western world today are mainly due to
2006) were retrieved and analyzed. surgery, malignancy, or radiation therapy.4,5 However, in
Results: Fifty-five patients with of genital tract fistula were developing countries, obstetric fistula had remained a
managed in the period under review, constituting 1.17% of significant but neglected problem that the World Health
total gynecological admissions. Obstetric fistula account- Organisation (WHO) has termed forgotten disease.6 It is
ed for 51 (93%) of genital fistula, and 92.7% of cases were a product of neglected labor, which is the hallmark of
caused by prolonged obstructed labor. The most common labor conducted by unskilled attendants in affected com-
form of fistula was the midvaginal type, and 89% of affected munities,7,8 and for many women in these countries, it
women were married with primiparous women mostly affect- has remained a significant health problem particularly in
ed (43.6%). Menstrual function was lost in 51% of the patients, sub-Saharan Africa.2,6
while obstetric palsy complicated 18.2% of the cases. Half of A United Nations report estimated that 2 million
the women (51%) were abandoned by their spouses, and women are living with the condition worldwide with
surgical repair was successful in only 32% of the cases. majority of sufferers located in sub-Saharan Africa.1,9
The WHO puts its annual incidence at 50 000 to 100 000
Conclusion: Obstetric fistula continues to show the defi-
new cases.6 Experts in fistula surgery in Africa further
ciency in women’s general health status occasioned by
suggest that the incidence ratio may be as high as 2 to 5
poor childbirth attendance in developing countries. Affect-
per 1000 women surviving delivery in areas where emer-
ed women suffer double jeopardy as a result of dearth of
gency obstetric services are not available.10
appropriate experts in fistula repair.
Keywords: obstetrics/gynecology PATIENTS AND METHODS
The case notes of patients managed for genital fistula
J Natl Med Assoc. 2009;101:593-595 over a 10-year period (January 1, 1997 to December 31,
2006) were retrieved and analyzed. There were 2 cases
Author Affiliations: Department of Obstetrics and Gynecology, Obafemi with incomplete information, which were dropped.
Awolowo University Teaching Hospitals Complex, Ile-Ife. Osun State, Nigeria.
Corresponding Author: Ajenifuja Kayode Olusegun. MBBS, FWACS
Socioeconomic and clinical data, including the age,
(firstname.lastname@example.org). parity, causes, complications, spousal support, examina-