Outcome of management of obstetric genito-urinary fistulae in the General Hospital, Ikot Ekpene, Akwa Ibom state, Nigeria

Abstract

Background: Obstetric fistula with urinary incontinence is 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. This study was carried out to assess the demographic and reproductive profiles as well as outcome of management of patients with obstetric genito-urinary fistulae in the General Hospital Ikot Ekpene, Akwa Ibom State, Nigeria. Design and Methods: A five-year cross sectional observational study of medical records of 37 patients managed in maternity section of General Hospital Ikot Ekpene, Akwa Ibom State, Nigeria was conducted. Results: One in every 122 deliveries during the study period was complicated by urinary fistula. Eleven (29.7%) were teenagers. Most patients were married (54.1%), primiparous (59.4%) from low socioeconomic class (72.9%) who did not utilize modern obstetric facilities effectively. Many cases were the consequence of prolonged obstructed labour (51.4%) and majority presented with total incontinence of urine (70.2%). Eighteen (48.7%) patients presented within 6 months of delivery. They were mainly vesico-vaginal (34.4%) or complex (10.8%) fistulae that were managed conservatively (21.6%) or with bladder repairs. About a third was referred for further management due to unsatisfactory outcome. Conclusions: This age-long obstetric morbidity is common among young married women in Ikot Ekpene, Akwa Ibom, mainly due to poor utilization of modern obstetric care facilities. Results of treatment are largely unsatisfactory in a third of these patients; therefore resources should be channeled towards effective and comprehensive preventive programs especially among this vulnerable group of women. © 2010 E.I. Ekanem et al.