The Obstetric Vesicovaginal Fistula: Characteristics of 899 Patients from Jos, Nigeria

Abstract

Objective: The purpose of this study was to describe the characteristics of women with obstetric vesicovaginal fistulas at a hospital in north central Nigeria. Study design: A retrospective record review was conducted of all women who were seen with vesicovaginal fistulas at Evangel Hospital in Jos, Plateau State, Nigeria, between January 1992 and June 1999. Results: A total of 932 fistula cases were identified, of which 899 cases (96.5%) were associated temporally with labor and delivery. The ‘‘typical patient’’ was small and short (44 kg and !150 cm); had been married early (15.5 years) but was now divorced or separated; was uneducated, poor, and from a rural area; had developed her fistula as a primigravida during a labor that lasted at least 2 days and which resulted in a stillborn fetus. Conclusion: Obstetric vesicovaginal fistula is extremely common in north central Nigeria. A complex interaction that involves multiple biologic and socioeconomic factors appears to predispose young women to this devastating childbirth injury. 2004 Elsevier Inc. All rights reserved.