Management of complex genital fistula: experience in a tertiary sub-Saharan hospital

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dc.contributor.authorAgwu, Ngwobia P.en_US
dc.contributor.authorAhmed, Abdullahi A.en_US
dc.contributor.authorMuhammad, Abubakar S.en_US
dc.contributor.authorMungadi, Ismaila A.en_US
dc.contributor.authorOyibo, Emmanuel U.en_US
dc.contributor.authorHassan, Mairoen_US
dc.date.accessioned2020-11-18T10:04:18Z
dc.date.available2020-11-18T10:04:18Z
dc.date.issued2020-04
dc.description.abstractBackground: Management of complex genital fistulae is challenging due to the cost and technical skill required. This study reports our experience in the management of patients with complex genital fistulae and to highlight the crucial role of the reconstructive urologists.Methods: This was a retrospective review of female patients managed at a tertiary hospital in Nigeria from 2006 to 2017 for complex urinary fistulae. Data were extracted from patient case notes and the data analysed using the SPSS software.Results: Twenty-four female patients mean age 28.9±11.1 years. Fistulae resulted from prolonged obstructed labour 10 (41.6%), caesarean hysterectomy 7 (29.2%), caesarean section and abdominal hysterectomy 2 (8.4%) respectively. The fistulae were vesicovaginal 16 (66.7%), ureterovaginal 3 (12.5%). Others were vesicocutaneous, urethrovaginal and rectovaginal. Prior attempts at repair were done in 7 (29.2%) and the number of attempts ranged from 1 to 4. Surgical procedures included direct closure in 9 (37.5%), closure and uretero-neocystostomy 7 (29.2%), uretero-neocystostomy only 3 (12.5%) closure and abdominal hysterectomy 2 (8.3%), closure and continent catheterizable neo-bladder 2 (8.3%) and 1 (4.2%) closure, abdominal hysterectomy and uretero-neocystostomy. Post-operative complications were noted in 2 (8.3%) and consisted of gynaeatresia and recurrent RVF. Repair was successful in 70.8% of patients while failed repair was recorded in 16.7% and while stress incontinence was present in 12.5%.Conclusions: Complex genital fistulae in our practice are of obstetric origin involving the bladder, ureters and rectum. The reconstructive urologist has a crucial role the management for a favourable outcome.en_US
dc.identifier.affiliationsDepartment of Surgery, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeriaen_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynaecology, College of Health Sciences, Usmanu Danfodiyo, Sokoto, Nigeriaen_US
dc.identifier.citationAgwu Ngwobia P., Ahmed Abdullahi A., Muhammad Abubakar S., Mungadi Ismaila A., Oyibo Emmanuel U., Hassan Mairo. Management of complex genital fistula: experience in a tertiary sub-Saharan hospital. International Surgery Journal. 2020 Apr; 7(4): 998-1003en_US
dc.identifier.issn2349-3305
dc.identifier.issn2349-2902
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/212914
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber4en_US
dc.relation.volume7en_US
dc.source.urihttps://dx.doi.org/10.18203/2349-2902.isj20201379en_US
dc.subjectComplex genital fistulaen_US
dc.subjectOutcomeen_US
dc.subjectRepairen_US
dc.titleManagement of complex genital fistula: experience in a tertiary sub-Saharan hospitalen_US
dc.typeJournal Articleen_US
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