Repair of obstetric vesicovaginal fistulas in Africa

Objective: The purpose of this study was to show the outcomes of primary surgical repair of obstetric vesicovaginal fistula repairs in Niger, Africa. Study design: From October 2003 to April 2005, 90 patients were examined with vesicovaginal fistulas and no previous repair. Fistulas were variable in location and degree of scarring and ranged up to 7 cm in size. All patients were offered surgical repair. Primary repair was performed in 73 women. Results: Successful primary closure was achieved in 41 patients (56%); 19 patients were lost to follow up, and 13 patients had a persistent fistula. Incontinence, despite fistula closure, was present in 9 patients. Common features of failure and/or incontinence included larger size, involvement of the urethrovesical junction, and scarring. Conclusion: The initial repair of vesicovaginal fistulas has the highest probability of success. The successful closure is dependent on size, site, and associated scarring.