title: Obstetric fistula: the ECWA Evangel VVF Center surgical experience from Jos, Nigeria.
abstract: OBJECTIVE
  The objectives of this study are to analyze the surgical outcomes of women undergoing obstetric fistula repair operations at the ECWA Evangel VVF Center, Jos, Nigeria, and to identify factors associated with postoperative urinary continence.
  
  
  METHODS
  Sociodemographic and clinical data were abstracted retrospectively from the Center's database for patients who underwent vesicovaginal fistula (VVF) repair operations. These data were compared with clinical outcome ("wet" or "dry") at the time of hospital discharge.
  
  
  RESULTS
  From August 1998 to April 2004, 1,084 fistula repair operations were performed on 926 patients. A vaginal approach was used in 90.1% of cases, and postsurgical continence was achieved in 70.5% of patients. Continence was more likely in patients with an intact urethra, an upper or midvaginal fistula, and less fibrosis than in those patients who remained wet.
  
  
  CONCLUSIONS
  Two thirds of patients with obstetric fistulas can be cured, with complete restoration of continence and low surgical morbidity, using a transvaginal surgical approach.
authors.affiliation: Department of Obstetrics & Gynecology, NorthShore University HealthSystem, Evanston, IL, USA. gckirschner@sbcglobal.net
authors.forename: Carolyn V
authors.initials: CV
authors.lastname: Kirschner
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Yost
authors.forename: Hongyan
authors.initials: H
authors.lastname: Du
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Karshima
authors.forename: Steven D
authors.initials: SD
authors.lastname: Arrowsmith
authors.forename: L Lewis
authors.initials: LL
authors.lastname: Wall
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014480:United Nations; D014549:Urinary Incontinence / Q000453:epidemiology; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D014719:Vesicovaginal Fistula / Q000453:epidemiology / Q000601:surgery*