Vesico vaginal fistula (VVF): a shift in epidemiology in northeastern Nigeria.

Abstract

Background: Vesico vaginal fistula is not only a medical disorder, but a serious social calamity. It reflects the state of health system failing to meet the basic needs of a growing population. Objective: To determine the epidemiological variables and outcome of the VVF patients.
Methodology: Eighty cases of VVF managed over the 10 year period was retrospectively studied. 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 during the period. About 76 % were over 20 years, with a peak-age specific prevalence rate of 33.8% at the 20-24 years age group. Teenagers accounted for 23.8%. Most (51.3%) sustained the VVF during their first childbirth, by the second delivery 78.8% were involved. All the teenagers had only one delivery. Majority had no supervised antenatal care and had their deliveries at home under TBAs. Prolonged obstructed labour was the leading cause in 90% and most were in social class IV and V ( using standard occupational classification, OPCS.). 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 too many. Now, afflicting not just teenagers and primipara, but predominantly, older and parous women. Public health education with the provision of accessible and efficient intrapartum care is the cornerstone to eradicating this problem.

Key words: VVF, epidemiology, northeastern, Nigeria, Maiduguri