title: Commonalities among women who experienced vesicovaginal fistulae as a result of obstetric trauma in Niger: results from a survey given at the National Hospital Fistula Center, Niamey, Niger.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the histories of women with urinary incontinence caused by vesicovaginal fistulae in Niger. This is an exploratory analysis to investigate possible contributing factors to the development of vesicovaginal fistulae.
  
  
  METHODS
  From September 2005 to January 2006, 58 women who were treated for vesicovaginal fistulae at the National Hospital Fistula Center, Niamey, Niger, were interviewed.
  
  
  RESULTS
  The average age of marriage was 15.6 years and of first pregnancy was 17.3 years; 44.9% of the women were primigravid; and 94.8% of the women began labor at home. By delivery, 91.4% of the women sought additional care. The average labor lasted 2.61 days. An average of 1.61 days passed before further assistance was sought; 91.4% of infants were stillborn.
  
  
  CONCLUSIONS
  Early marriage, young age at first pregnancy, and labor length are common findings in our population of women with vesicovaginal fistulae. Most women who experienced fistulae also had poor obstetric outcomes. Increasing access to emergency obstetric care is of paramount importance to prevent fistula formation.
authors.affiliation: Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Larissa
authors.initials: L
authors.lastname: Meyer
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Ascher-Walsh
authors.forename: Rachael
authors.initials: R
authors.lastname: Norman
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Idrissa
authors.forename: Hadley
authors.initials: H
authors.lastname: Herbert
authors.forename: Oumou
authors.initials: O
authors.lastname: Kimso
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wilkinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D020073:Gravidity; D006801:Humans; D009548:Niger / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology*; D014719:Vesicovaginal Fistula / Q000209:etiology*