title: Vesicovaginal fistula: a review of nigerian experience.
abstract: BACKGROUND
  Vesicovaginal fistula is a preventable calamity, which has been an age-long menace in developing countries.
  
  
  OBJECTIVE
  To review the causes, complications, and outcome of Vesicovaginal fistula in Nigeria.
  
  
  METHODS
  Studies on Vesicovaginal fistula were searched on the internet. Information was obtained on PubMed(medline), WHO website, Bioline International, African Journal of Line, Google scholar, Yahoo, Medscape and e Medicine.
  
  
  RESULTS
  Many Nigerian women are living with Vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria that southern Nigeria. Obstetric fistula accounts for 84.1%-100% of the Vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9%-96.5%) in all the series. Other common causes include caesarean section, advanced cervical cancer, uterine rupture, and Gishiri cut. The identified predisposing factors were early marriage and pregnancy, which were rampant in northern Nigeria, while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance and were poverty, illiteracy, ignorance, restriction of women's movement, non-permission from husband and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87%-91.7%. Stigmatization, divorce and social exclusion were common complications. Overall fistula repair success rate was between 75% and 92% in a few centres that offer such services.
  
  
  CONCLUSIONS
  Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern.
authors.affiliation: Department of Obstetrics & Gynaecology, University of Ilorin Teaching Hospital, Maternity Hospital Wing, PMB 1339. Ilorin, Nigeria. munirijaiya@yahoo.com
authors.forename: M A
authors.initials: MA
authors.lastname: Ijaiya
authors.forename: A G
authors.initials: AG
authors.lastname: Rahman
authors.forename: A P
authors.initials: AP
authors.lastname: Aboyeji
authors.forename: A W
authors.initials: AW
authors.lastname: Olatinwo
authors.forename: S A
authors.initials: SA
authors.lastname: Esuga
authors.forename: O K
authors.initials: OK
authors.lastname: Ogah
authors.forename: H O
authors.initials: HO
authors.lastname: Raji
authors.forename: I O
authors.initials: IO
authors.lastname: Adebara
authors.forename: A O
authors.initials: AO
authors.lastname: Akintobi
authors.forename: A S
authors.initials: AS
authors.lastname: Adeniran
authors.forename: A A
authors.initials: AA
authors.lastname: Adewole
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D017668:Age of Onset; D044383:Black People; D005260:Female; D006801:Humans; D008499:Medical Records; D009549:Nigeria / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D015995:Prevalence; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014719:Vesicovaginal Fistula / Q000150:complications / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery