Epidemiology of vesico vaginal fistula in Maiduguri

Abstract

Background: Vesico vaginal fistula commonly affects the poor, less educated, teenage group and those experiencing their first deliveries.

Objective: To determine the epidemiological variables r associated with vesico vaginal fistula.

Methodology: A total of 80 case records of VVF patients managed over a 10 year period were retrospectively studied. Relevant information pertaining to age, parity, and cause of VVF and outcome of management were retrieved from the case notes. The data was analyzed using SPSS package.

Results: VVF Constituted 1.4%, of the total Gynecological admissions and 8.0% of the major Gynecological surgeries performed during the period. The prevalence was highest among the Hausa/Fulani and the Kanuris. Majority (76.2%) were over 20 years, with a peak-age specific prevalence rate of 33.8% at the 20- 24 years age group. Teenagers only accounted for 23.8%. Most patients sustained the VVF during their first childbirth (51.3%), by the second delivery 78.8% were involved. All the teenagers had only one delivery, while all the grandmultipara were 40 years and above. Ninety percent of them had no supervised antenatal care and had their deliveries at home under traditional birth attendant (TBAs). In about 90% prolong obstructed labour was the leading cause and most patients belong to the social class IV and V. Seventy five percent had successful repair, while about 50% were either divorced or neglected by their husbands.

Conclusion: Vesico-vaginal fistula remains one preventable medical/social calamity, now afflicting not just teenagers and primipara, but predominantly older and parous women. Public health education with the provision of accessible efficient intrapartum care is the cornerstone to eradicating this problem.