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Updated: Jul 18, 2026
Removal of an Intravesical Gellhorn Pessary and Staged Repair of a Residual Large Vesico-Vaginal Fistula
Published on: April 14, 2026
Repair of obstetric vesicovaginal fistulas in Africa
Marcella L Roenneburg1, Rene Genadry, Clifford R Wheeless
1Department of Gynecology and Obstetrics, Mercy Medical Center, Baltimore, MD 21202, USA. mroenneburg@mdmercy.com
Objective:
The purpose of this study was to show the outcomes of primary surgical repair of obstetric vesicovaginal fistula repairs in Niger, Africa.
Study Design:
From October 2003 to April 2005, 90 patients were examined with vesicovaginal fistulas and no previous repair. Fistulas were variable in location and degree of scarring and ranged up to 7 cm in size. All patients were offered surgical repair. Primary repair was performed in 73 women.
Results:
Successful primary closure was achieved in 41 patients (56%); 19 patients were lost to follow up, and 13 patients had a persistent fistula. Incontinence, despite fistula closure, was present in 9 patients. Common features of failure and/or incontinence included larger size, involvement of the urethrovesical junction, and scarring.
Conclusion:
The initial repair of vesicovaginal fistulas has the highest probability of success. The successful closure is dependent on size, site, and associated scarring.
