Outcome of Vesicovaginal Fistula Repair: An Experience at Hamlin Fistula Hospital, Ethiopia

Aim and objective: The purpose of this study was to assess the outcomes of surgical repair of obstetric vesicovaginal fistula repairs at Hamlin Fistula Hospital, Ethiopia.Materials and methods: This is a case series study of vesicovaginal fistula repair at Hamlin fistula hospital, Addis Ababa and Hamlin Fistula Centre, Yirgalem, Ethiopia.All women were operated under spinal anesthesia.Bladder was kept empty with free drainage for 14 days.Upon removal of catheter woman was asked to pass urine and postvoid ultrasound was done.They were followed up at 6 and 12 months.The fistula was classified according to the Goh classification system.Surgical outcomes of the surgery were "Fistula closed + patient continent, " "Fistula closed + patient incontinent, " "Fistula not closed + patient incontinent." Results: A total of 17 cases operated independently.All the fistulas were associated with complications of labor and delivery.Prolonged obstructed labor was found in all 17 women.Sixteen out of seventeen patients were dry during immediate postoperative period.Successful closure was achieved in 11 patients (65%), despite fistula closure; stress incontinence was present in 5 (35%) patients at 6 months and 1 year follow-up.However, one patient was wet on operative evening.Her left ureter was in the scar and unidentifiable during surgery.Conclusion: The successful repair depends upon site, size, duration of fistula, and degree of scarring.However, some patients remained wet after successful closure due to incontinence problems. Clinical significance:The Goh classification has good prognostic value in determining the risk of urinary incontinence after anatomical closure of vesicovaginal fistulae.