title: Repair of obstetric vesicovaginal fistulas in Africa.
abstract: OBJECTIVE
  The purpose of this study was to show the outcomes of primary surgical repair of obstetric vesicovaginal fistula repairs in Niger, Africa.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  The initial repair of vesicovaginal fistulas has the highest probability of success. The successful closure is dependent on size, site, and associated scarring.
authors.affiliation: Department of Gynecology and Obstetrics, Mercy Medical Center, Baltimore, MD 21202, USA. mroenneburg@mdmercy.com
authors.forename: Marcella L
authors.initials: ML
authors.lastname: Roenneburg
authors.forename: Rene
authors.initials: R
authors.lastname: Genadry
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Wheeless
mesh_terms: D000349:Africa; D002921:Cicatrix / Q000209:etiology; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications; D011247:Pregnancy; D012086:Reoperation; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology; D014719:Vesicovaginal Fistula / Q000150:complications / Q000209:etiology* / Q000601:surgery*