title: Decreasing incidence and changing aetiological factors of vesico-vaginal fistula in south-east Nigeria.
abstract: This study retrospectively reviewed 476 cases of vesico-vaginal fistula (VVF) in the University of Nigeria Teaching Hospital Enugu, south-east Nigeria from 1981 to 2005. The majority (86.6%) of the VVFs were of obstetric origin, resulting from vaginal delivery (n = 330), caesarean section (n = 35), caesarean hysterectomy (n = 26) and instrumental delivery (n = 21). The remaining 13.4% (n = 64) resulted from pelvic surgery, malignancy and radiotherapy treatment. The contribution of obstetrics to VVF development showed a downward trend from 95% in 1981 to 60% in 2005. A success rate of 83% was recorded in the repair with large sized fistula and extensive fibrosis at the fistula site contributing mostly to failure. There is a need to increase access to trained delivery attendants to sustain the downward trend in the incidence of VVF.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria. samnobis@yahoo.co.uk
authors.forename: S N
authors.initials: SN
authors.lastname: Obi
authors.forename: B C
authors.initials: BC
authors.lastname: Ozumba
authors.forename: A K
authors.initials: AK
authors.lastname: Onyebuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005355:Fibrosis; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D014719:Vesicovaginal Fistula / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D055815:Young Adult