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Profile and outcome of patients with recurrent urogenital fistula in a fistula centre in Nigeria

  • Temitope Omoladun Okunola
  • Emmanuel Yakubu
  • Babafemi Daniyan
  • Kenneth Ekwedigwe
  • Monday Eliboh
  • Ileogben Sunday-Adeoye
Original Article
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Abstract

Introduction and hypothesis

Management of a recurrent urogenital fistula is very challenging and requires experienced surgeons. The aim of this study was to describe the characteristics, success rates, and associated factors related to surgical repairs of patients with recurrent urogenital fistulas by an experienced team at a fistula centre in Nigeria.

Methods

This was a retrospective cohort study of 154 patients that had repeat urogenital fistula repairs at the National Obstetric Fistula Centre, Abakaliki, Nigeria, between January 2014 and December 2016. Information was retrieved from their hospital records. Successful repair was defined by continent status at 3 months after repair. Data were analyzed with SPSS version 20 by IBM Inc., and p < 0.05 was taken as statistically significant. Chi-square test was used to determine the association between the factors and successful repair.

Results

The mean age was 36.27 ± 12.96 years. Obstetric fistula occurred in 92.2% of the patients. The success rates for the first, second, third, and fourth repeat repairs were 68.8%. 56.2%, 50%, and 0% respectively. Significant factors were the number of previous attempts at repair (χ2 = 20.44, p = 0.002), age group (χ2 = 16.95, p = 0.03), Waaldijk’s classification (χ2 = 13.31, p = 0.04), duration of fistula (χ2 = 19.6, p = 0.03), surgeons’ experience (χ2 = 7.11, p = 0.04), and place of previous attempt at repair (χ2 = 6.35, p = 0.02). There were no complications in 86.4%.

Conclusions

The success rate was good. Patients who had previous failed repairs at the fistula centre had better outcomes after the repeat surgeries. Centralizing fistula care will enhance optimal outcomes. It may also boost training and research in this specialty.

Keywords

Urogenital fistula Continence Success rate Previous failed repair 
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Notes

Acknowledgements

The authors appreciate Mrs. Marcelina who helped to retrieve the patients’ records.

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologyState Specialist HospitalIkere-EkitiNigeria
  2. 2.National Obstetric Fistula CentreAbakalikiNigeria

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