title: Characteristics and surgical success of patients presenting for repair of obstetric fistula in western Kenya.
abstract: OBJECTIVE
  To carry out a large-scale retrospective review of patients who had undergone surgical repair of obstetric fistula in Kenya to determine patient characteristics and determinants of successful surgical repair.
  
  
  METHODS
  The patient records of 483 surgical repairs of obstetric fistula treated by a single surgeon (H.M.) between January 2005 and July 2010 at 3 medical centers in western Kenya were retrospectively reviewed. Descriptive and bivariate statistical analyses were performed.
  
  
  RESULTS
  Young women with some primary or no education and prolonged labor at the time of first delivery were most highly correlated with obstetric fistula formation. Success of fistula closure was 86% for first-time vesicovaginal fistula (VVF) repairs and 67% for first-time VVF combined with rectovaginal fistula (RVF) repairs. Among women who had previously attempted VVF or combined VVF/RVF repairs, 73% and 50% of fistulas, respectively, were repaired successfully. First-time repair was significantly associated with surgical success compared with patients with a history of previous repair attempts (P=0.027).
  
  
  CONCLUSIONS
  Among Kenyan women presenting for fistula repair, fistula most was most highly correlated with a low level of education and prolonged labor. The findings are consistent with results reported from other countries in Sub-Saharan Africa.
authors.affiliation: Faculty of Medicine, University of Toronto, Ontario, Canada.
authors.forename: Lesley
authors.initials: L
authors.lastname: Hawkins
authors.forename: Rachel F
authors.initials: RF
authors.lastname: Spitzer
authors.forename: Astrid
authors.initials: A
authors.lastname: Christoffersen-Deb
authors.forename: Jessica
authors.initials: J
authors.lastname: Leah
authors.forename: Hillary
authors.initials: H
authors.lastname: Mabeya
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D011247:Pregnancy; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data; D012006:Rectovaginal Fistula / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D014719:Vesicovaginal Fistula / Q000453:epidemiology* / Q000601:surgery; D055815:Young Adult