Profile of Obstetric and Iatrogenic Fistula Surgeries at Kathmandu Model Hospital

  • Ranjana Shrestha Department of Obstetrics and Gynecology, Kathmandu Model Hospital, Nepal
  • Aruna Karki Department of Obstetrics and Gynecology, Kathmandu Model Hospital, Kathmandu
  • Ganesh Dangal Department of Obstetrics and Gynecology, Kathmandu Model Hospital, Nepal
  • Hema Pradhan Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Kathmandu. Nepal
  • Kabin Bhattachan Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Kathmandu. Nepal
  • Rekha Poudel Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Kathmandu. Nepal
  • Nishma Bajracharya Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Kathmandu. Nepal
  • Kenusha Devi Tiwari Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal

Abstract

Aims: Vesico-vaginal fi stula (VVF) is an abnormal fi stulous communication between the bladder and/or urethra and the vagina that allows continuous involuntary discharge of urine into the vaginal vault affecting patients’ medical, physical, mental, social and sexual life. The aim of this study was to review and deliver a profi le, their demography and outcome in the early phase of fi stula surgery performed in our institute.


Methods: This was a retrospective study of 222 patients who underwent fi stula surgery during the period of January 2012 to March 2018 in Kathmandu Model Hospital. The fi stula were classifi ed according to Goh`s system. Patients’ demography, obstetric characteristics and fi stula repair outcomes were reviewed. The primary outcome was in terms of urinary continence.


Results: A total of 222 women aged between 10 to 65 years with a mean age of 31.4 were included. Majority of the patients had fi stula due to obstetrical cause, contributing 58% (n=127) and in 42 % (n=95) of patients had fi stula of gynecological etiology. Most of the patients had fi stula of type 1a, contributing 38% (n=84) and only 0.01% (n=3) of type 3c and 4b according to Goh’s classifi cation. Among 127 fi stulas repaired of obstetric etiology100 (78.7%) patients and 85 (89.4%) out of 95 fi stula patients of gynecological cause were continent and dry.


Conclusions: Our study showed obstructed and prolonged labor was the major cause of obstetric fi stula, however iatrogenic fi stula was also becoming common. Majority of our cases had successful outcome with some degree of stress in some patients.


Keywords: fi stula repair, iatrogenic fi stula, obstetric fi stula, vesicovaginal fi stula.

Published
Jan 21, 2019
How to Cite
SHRESTHA, Ranjana et al. Profile of Obstetric and Iatrogenic Fistula Surgeries at Kathmandu Model Hospital. Nepal Journal of Obstetrics and Gynaecology, [S.l.], v. 13, n. 2, p. 19-22, jan. 2019. ISSN 1999-8546. Available at: <http://njog.org.np/njog/index.php/njog/article/view/946>. Date accessed: 24 june 2019.
Section
Original Articles