Vesico-vaginal fistula in Jordan

In order to study the aetiology of vesico-vaginal fistula in Jordan, and assess the outcome of surgical treatment, 132 cases of acquired vesico-vaginal fistulae treated at Al-Bashir Hospital, and Jordan University Hospital, Amman, Jordan, during the period between 1972 and 1996 were reviewed. Forty-five cases (30%) had one or more previous failed repair outside these hospitals. Successful repair of 108 cases was achieved (82%), 60 cases of them from the first attempt (45%) and, 48 other cases after repeated attempts (36%). In 24 cases, a total of 72 repeated operations failed. Obstetric fistulae in Jordan are decreasing due to improvement and expansion of maternity care. Although a patient with neglected fistula is a social problem, this is not the case in Jordan because of the strong family ties. Nevertheless, they present a great challenge to the gynaecologist. Referral to a centre experienced in this type of surgery certainly improves the success rate, and diminish the suffering of these patients.