Vesico-vaginal fistula in Eastern Nigeria

Our objective was to examine the epidemiological determinants of vesico-vaginal fistula in Eastern Nigeria, and maternal characteristics and sociocultural factors predisposing to vesico-vaginal fistula. The case-records of 74 patients with vesico-vaginal fistula were reviewed. The mean age of the patients was 34.1 years and the mean age at occurrence of fistula was 30.1 years. A total of 24 women (32.4%) presented within 6 months of fistula formation. They were mainly multipara, housewives, subsistence farmers and still living with their husbands. A total of 68 (91.9%) developed a fistula following prolonged obstructed labour. Juxta-cervical fistula was the most common, 33 (44.6%) followed by juxta-urethral 11 (14.9%). The other associated morbidity included chronic vulval excoriation, cervical damage and amenorrhoea. Fetal wastage was high with 53 (77.9%) stillbirths and four (5.9%) early neonatal deaths. Vesico-vaginal fistula is still a major problem in the developing countries and a reflection of standard of obstetric care currently available to our women.