title: Urinary symptoms and urodynamics following obstetric genitourinary fistula repair.
abstract: OBJECTIVE
  The aim of this study was to evaluate urinary symptoms and urodynamic diagnoses in women following repair of obstetric fistula of the lower urinary tract.
  
  
  METHODS
  Women with previous genital tract fistula and ongoing urinary symptoms were evaluated at the Addis Ababa Fistula Hospital. The women were referred to the Urodynamic Unit by doctors reviewing women at the hospital. Consecutive women between December 2008 and September 2009 were assessed (including urodynamic studies) and data collected
  
  
  RESULTS
  One hundred and fifty-four women were referred for urodynamic assessment. Only women with previous obstetric fistula were included in the study. Of the 154 women, 5 were excluded from the study-1 declined the assessment, 1 had a non-obstetric fistula and 3 were found to have recurrence of the fistula. Forty-nine percent had urodynamic stress incontinence only, 3 % had detrusor overactivity only and 43 % had both urodynamic stress incontinence and detrusor overactivity. Five percent of women had neither detrusor overactivity nor urodynamic stress incontinence. Seven percent had post-void residual volume of 150 ml or more.
  
  
  CONCLUSIONS
  Non-surgical management of post-obstetric fistula urinary symptoms may be neglected. The reduced success rates in surgery for post-obstetric fistula urinary incontinence may be due to the lack of attention to the other reasons for urinary symptoms and markedly impaired urethral function. Urethral closure pressures in this group of women often did not reflect the severity of urinary incontinence.
authors.affiliation: Greenslopes Private Hospital, Ramsay Specialist Centre, Suite 209, Newdegate Street, Greenslopes, QLD, Australia. jtwgoh@hotmail.com
authors.forename: Judith T W
authors.initials: JT
authors.lastname: Goh
authors.forename: Hannah
authors.initials: H
authors.lastname: Krause
authors.forename: Azeb B
authors.initials: AB
authors.lastname: Tessema
authors.forename: Genet
authors.initials: G
authors.lastname: Abraha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D036861:Delivery, Obstetric / Q000009:adverse effects*; D019468:Disease Management; D005002:Ethiopia; D005260:Female; D052776:Female Urogenital Diseases / Q000209:etiology / Q000601:surgery*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000453:epidemiology* / Q000503:physiopathology; D014548:Urinary Fistula / Q000209:etiology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*; D055815:Young Adult