Review of Obstetrics Genito-urinary Fistulae in the University of Calabar Teaching Hospital Calabar, Nigeria

Obstetric fistulae with Urinary incontinence are one of the most distressing maternal morbidities. It is associated with physical and social deprivation such as wife abandonment and violent reactions against the victims particularly in the developing countries of the world. To study the demographic and reproductive profiles as well as management of patientswith obstetric fistulae inUCTH,Calabar,Nigeria. Afiver-year retrospective study of case records of 37 patients managed inMaternity Annex of University of Calabar Teaching Hospital, Calabar Nigeria for obstetric genito-urinary fistulae was carried out. One in every 122 parturients during the period had fistula. Eleven (29.7%) were teenagers. Many patients weremarried (54.1%), nulliparous (59.4%), come from low socioeconomic class (72.9%) and did not utilize modern obstetric facilities properly. Many cases resulted from prolonged obstructed labour (51.4%) and 70.2% presented with total incontinence of urine. Eighteen (48.7%)were diagnosed within 6 month of delivery. Themain types encountered includedwere vesico-vaginal (34.4%) or complex (10.8%) fistulaewho were manage conservatively (21.6%) or with bladder repairs. Majority (29.7 %) were referred for further treatment. Parturient in Calabar still suffer from this age long obstetric morbidity mainly due to poor utilization of modern obstetric care facilities. Results of treatment are largely unsatisfactory; therefore resources should be channeled towards prevention.Keywords: Obstetrics, : Genito-urinary, fistula

Vesicovaginal fistula presenting as urogenital prolapse

Vesicovaginal fistula (VVF) is an abnormal fistulous communication between the bladder and the vagina that allows continuous involuntary discharge of urine into the vagina. It is one of the most abhorred morbidities in obstetric practice because of the profound effect on the patient’s emotional well‑being. Here, we present a case of VVF presenting as urogenital prolapse following an automobile accident. A large fistulous defect with complete bladder base prolapse was successfully repaired with adequate flap mobilization after two failed attempts by a surgical team. VVF should be considered in cases of urogenital prolapse especially following traumatic pelvic injuries.Keywords: Bladder base; trauma; urogenital; vesicovaginal fistul