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Obstetric fistula

Jeffrey P Wilkinson, Angela M Bengtson, Ennet Chipungu, Rachel J Pope, Bonus Makanani, Margaret Moyo, Mwawi Mwale, Jennifer H Tang
Objective: Obstetric fistula (OF) is a morbid condition caused by prolonged obstructed labor. Women with OF experience profound injury and have high rates of infertility and poor obstetric outcomes. We examined endovaginal ultrasound parameters in women with and without OF. Design/Setting/Sample/Methods: This cross-sectional study enrolled women evaluated at the Fistula Care Centre in Lilongwe, Malawi. Eligibility criteria included age 18-45, prior pregnancy, and a uterus on ultrasound...
2018: Obstetrics and Gynecology International
Fiona Katherine McCurdie, Joanne Moffatt, Kevin Jones
Kitovu Hospital in Masaka, Uganda, is a leading obstetric fistula repair centre in the country with the highest rates of fistula in the world. In this retrospective case review, the regional incidence and causative factors were studied in patients with vesicovaginal fistula (VVF) who were admitted at Kitovu Hospital. Fistula history included severity (ICIQ score), causes and outcomes of VVF were measured. Women suffered with symptoms of VVF for an average of 4.97 years with an average ICIQ severity score of 7...
March 9, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
L Lewis Wall
OBJECTIVES: To review the historical background surrounding the early work of Dr. J. Marion Sims, who developed the first consistently successful surgical technique for the repair of obstetric vesicovaginal fistulas by operating on a group of young, enslaved, African American women who had this condition between 1846 and 1849. METHODS: Review of primary source documents on Sims and his operations, early 19th century clinical literature on the treatment of vesicovaginal fistula, the introduction of ether and chloroform anesthesia into surgical practice, and the literature on the early 19th century medical ethics pertaining to surgical innovation...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Sunday Lengmang, Steven Shephard, Avisek Datta, Svjetlana Lozo, Carolyn V Kirschner
INTRODUCTION AND HYPOTHESIS: For decades, the pubovesical (PV) sling has been in the armamentarium of the fistula surgeon for treating persistent urinary incontinence after successful fistula closure. We report our early experience with slings, and then also introduce a new "tight" PV sling technique for management of post-fistula urethral leak. Our hypothesis is that performance of tight slings might result in improved continence for women with persistent urinary incontinence after obstetric fistula closure...
February 21, 2018: International Urogynecology Journal
M Regina Torloni, Rachel Riera, Ewelina Rogozińska, Özge Tunçalp, A Metin Gülmezoglu, Mariana Widmer
BACKGROUND: Bladder catheterization duration after urinary obstetric fistula surgery varies widely. OBJECTIVE: To assess the effect of bladder catheterization duration after urinary obstetric fistula surgery. SEARCH STRATEGY: Medline, EMBASE, CINAHL, GIM, and POPLINE databases were searched, without language restrictions, using "obstetric urinary fistula" and "catheterization" from inception to September 30, 2017. SELECTION CRITERIA: Randomized controlled trials comparing shorter versus longer (>10 days) bladder catheterization after urinary obstetric fistula repair were included...
February 13, 2018: International Journal of Gynaecology and Obstetrics
Bonnie Ruder, Melissa Cheyney, Alice Aturo Emasu
Uganda has one of the highest obstetric fistula rates in the world with approximately 200,000 women currently suffering. Surgical closure successfully treats fistula in the majority of cases, yet there is a severe shortage of facilities and trained surgeons in low-resource countries. The purpose of this study was to examine Ugandan women's experiences of obstetric fistula with the aim of adding narrative depth to the clinical literature on this devastating birth injury. Data were collected through semistructured interviews, focus groups, and participant observation...
February 1, 2018: Qualitative Health Research
S Norderval, L Lundby, H Hougaard, S Buntzen, S Weum, L de Weerd
BACKGROUND: Injection of autologous fat is an established method within plastic surgery for soft tissue augmentation. The aim of the present study was to determine whether transperineal fat graft injection could promote healing of anovaginal fistulas. METHODS: The procedures were performed at the University Hospital of North Norway, Tromsø, Norway, and at Aarhus University Hospital, Aarhus, Denmark, between May 2009 and September 2016. After abdominal liposuction, fat was injected around the fistula tract that was finally transected percutaneously with a sharp cannula and fat injected between the cut parts...
December 28, 2017: Techniques in Coloproctology
P Letchworth, E MacLaren, S Duffy
The impact of an obstetric fistula on a woman's quality of life is catastrophic. It is a devastating condition that affects the most vulnerable women in society. In 2006 the World Health Organisation (WHO) estimated that two million women throughout the world live with an untreated fistula, with between 50,000 and 100,000 new cases occurring each year. This article is protected by copyright. All rights reserved.
December 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
Marielle Meurice, Rene Genadry, Carol Heimer, Galya Ruffer, Barageine Justus Kafunjo
BACKGROUND: Obstetric fistula is a preventable and treatable condition predominately affecting women in low-income countries. Understanding the social context of obstetric fistula may lead to improved prevention and treatment. OBJECTIVES: This study investigated social experiences of women with obstetric fistula seeking treatment at Mulago Hospital in Kampala, Uganda. METHODS: A descriptive study was conducted among women seeking treatment for obstetric fistula during a surgical camp in July 2011 using a structured questionnaire...
May 2017: Annals of Global Health
Dawn M Kopp, Jeffrey Wilkinson, Angela Bengtson, Ennet Chipungu, Rachel J Pope, Margaret Moyo, Jennifer H Tang
BACKGROUND: Obstetric fistula (OF) is a maternal morbidity associated with high rates of stillbirth, amenorrhea, and sexual dysfunction. Limited data exists on the reproductive outcomes of women in the years following a fistula repair. The objective of this study is to describe the fertility outcomes and family planning practices in a population of Malawian women 1-4 years after fistula repair. METHODS: Women who had enrolled into a clinical database of OF patients and undergone OF repair between January 1, 2012 and July 31, 2014 were recruited and enrolled to complete a home-based survey of their demographic and reproductive health data 1-4 years after their repair...
November 28, 2017: Reproductive Health
Dawn M Kopp, Angela Bengtson, Jeffrey Wilkinson, Ennet Chipungu, Margaret Moyo, Jennifer H Tang
OBJECTIVES: Unintended pregnancy contributes to morbidities, such as obstetric fistula. Furthermore, after fistula repair, women should avoid pregnancy for a year to prevent its breakdown. Our study objective was to evaluate the contraceptive knowledge, practices and intentions of women undergoing obstetric fistula repair at a centre in Malawi. METHODS: This cross-sectional study used a standardised survey to examine the contraceptive knowledge, practices and intentions of women undergoing obstetric fistula repair in Lilongwe, Malawi, between September 2011 and November 2014...
October 2017: European Journal of Contraception & Reproductive Health Care
Athanase Lilungulu, Willy Mwibea, Mzee Nassoro, Balthazar Gumodoka
Background. Haematometra is a rare postobstetrics fistula surgical repair outcome complication; however the condition can be misinterpreted especially in limited resource areas that lack routine ultrasound guidance and with a slowly progressed increase in size of abdomen accompanied with a history of amenorrhoea together with a history of having unprotective sexual intercourse which may increase the possibility of being controversial to full-term gravid uterus. The causes of haematometra might be either due to congenital abnormality of the vaginal canal or acquired iatrogenically...
2017: Case Reports in Obstetrics and Gynecology
Sibone Mocumbi, Claudia Hanson, Ulf Högberg, Helena Boene, Peter von Dadelszen, Anna Bergström, Khátia Munguambe, Esperança Sevene
BACKGROUND: Obstetric fistula is one of the most devastating consequences of unmet needs in obstetric services. Systematic reviews suggest that the pooled incidence of fistulae in community-based studies is 0.09 per 1000 recently pregnant women; however, as facility delivery is increasing, for the most part, in Africa, incidence of fistula should decrease. Few population-based studies on fistulae have been undertaken in Sub-Saharan Africa, including Mozambique. This study aimed to estimate the incidence of obstetric fistulae in recently delivered mothers, and to describe the clinical characteristics and care, as well as the outcome, after surgical repair...
November 10, 2017: Reproductive Health
Rebecca G Maine, Allison F Linden, Robert Riviello, Emmanuel Kamanzi, Gita N Mody, Georges Ntakiyiruta, Grace Kansayisa, Edmond Ntaganda, Francine Niyonkuru, Joel M Mubiligi, Tharcisse Mpunga, John G Meara, Bethany L Hedt-Gauthier
Importance: In low- and middle-income countries, community-level surgical epidemiology is largely undefined. Accurate community-level surgical epidemiology is necessary for surgical health systems planning. Objective: To determine the prevalence of surgical conditions in Burera District, Northern Province, Rwanda. Design, Setting, and Participants: A cross-sectional study with a 2-stage cluster sample design (at village and household level) was carried out in Burera District in March and May 2012...
October 25, 2017: JAMA Surgery
Fatemah Al Hadhoud, Abeer H Kamal, Abdulmohsen Al Anjari, Michael Fe Diejomaoh
BACKGROUND: Fused lower limbs combined with severe urogenital malformation, also known as sirenomelia, is a rare congenital clinical syndrome. The etiology is unknown, and the outcome for the affected fetus is rather uncertain. CASE REPORT: Mrs RB, a Kuwaiti woman primigravida, married to a non-consanguineous husband, had uneventful antenatal care in a private health service, until she was admitted to the Maternity Hospital, Kuwait, at 31 weeks of gestation with a 3-hour history of ruptured membranes...
2017: International Medical Case Reports Journal
R Pope, J Wilkinson
No abstract text is available yet for this article.
October 14, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
A Browning, G Williams, P Petros
Our aim was to describe a new surgical method for prophylaxis/cure of post obstetric fistula repair leakage based on restoring vaginal elasticity with Singapore skin flap. The rationale for this operation was based on the integral theory: scarring removes elasticity required for independent function of oppositely acting urethral closure forces so they become 'tethered, forcibly opening the urethra when give the signal to close'. Skin graft restores elasticity and closure. Used prophylactically with Goh type 4 fistula (n = 45), 46% were dry against an expected 19%...
October 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
Thomas J I P Raassen, Carrie J Ngongo, Marietta M Mahendeka
INTRODUCTION: Ureteric injuries are among the most serious complications of pelvic surgery. The incidence in low-resource settings is not well documented. METHODS: This retrospective review analyzes a cohort of 365 ureteric injuries with ureterovaginal fistulas in 353 women following obstetric and gynecologic operations in 11 countries in Africa and Asia, all low-resource settings. The patients with ureteric injury were stratified into three groups according to the initial surgery: (a) obstetric operations, (b) gynecologic operations, and (c) vesicovaginal fistula (VVF) repairs...
October 11, 2017: International Urogynecology Journal
R J Pope, R H Brown, E Chipungu, L H Hollier, J P Wilkinson
Gynecologic and plastic surgeons collaborate to improve vaginal reconstruction for women with vaginal stenosis and obstetric fistula. As these cases occur typically in low-resource settings, the Singapore flap is a useful technique given its reliability, safety, ease of dissection, and minimal need for additional supplies. The fasciocutaneous flap maintains cutaneous innervation and vasculature and does not require stenting. The surgical collaboration has made it possible to provide functional vaginal reconstruction as a part of the overall care of obstetric fistula patients...
October 5, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
Rafał Watrowski, Burghardt Babbel, Gerald Gitsch
Less than 10 deliveries via cervicovaginal fistula (CVF) with closed cervical os were reported so far. In the majority of cases, the patients had a history of induced abortions. The CVF was usually recognized due to postpartum hemorrhage. The facilitating role of prostaglandins used for labor induction was supposed. In all cases, the babies remained unaffected by the delivery route. We report a new case of a 37-year-old gravida 2, para 0, with a history of a paracervical tear following a first trimester abortion 11 years ago...
October 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
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