Failure factors for surgical treatment of obstetric fistula: about 49 cases operated at the district hospital of Tanguieta, northern Benin, in 2018

Abstract

Introduction: Obstetric Fistula is a drama that still affects many women, especially in developing countries.

Objective: To analyze the failure factors of surgical treatment of obstetric fistulas.

Methods: This was a cross-sectional and analytical study carried out at the District Hospital of Tanguiéta from March 28th to July 20th, 2018. The study concerned all the women operated in the hospital during the period Study for Obstetric Fistula Occurred After Vaginal Delivery. The confidentiality of the data and the anonymity of the women have been respected.

Results: The study involved 49 women with obstetric fistula including 42 cases of vesico-vaginal fistula, 5 cases of vesico-uterine fistulas and 2 cases of rectovaginal fistula. The mean age of the patients was 35.59 +/- 12.81 years. The average age of onset of fistula was 28.45 +/- 7.73 years. The fistula was associated with an attack of the urethra in 9 cases and the bladder neck was damaged in 8 cases. The cure rate was 81.6%. Treatment failure was more observed in women who had fistula before the age of 18 [OR11.2 95% CI (2.1-59.9)] and fistula associated with either the damaged bladder neck [ OR 15.4 95% CI (2.6-90)], or one damaged urethra [OR 5.6 95% CI (1.1-28.1)].

Conclusion: This study confirmed the hope of recovery after surgical treatment of obstetric fistula. This hope may be better in the absence of factors such as the age of early onset fistula, urethral involvement and bladder neck involvement.