title: Uncomplicated midvaginal vesico-vaginal fistula repair in ibadan: a comparison of the abdominal and vaginal routes.
abstract: BACKGROUND
  Obstetric fistula is a resultant effect of prolonged obstructed labour. The best surgical management of simple uncomplicated fistula determines the outcome of care.
  
  
  OBJECTIVE
  To compare outcome of uncomplicated mid-vaginal fistula between vaginal and abdominal route of repair.
  
  
  METHODS
  This was a hospital based retrospective study conducted at the University College Hospital, Ibadan from January, 2000 till December, 2006.
  
  
  RESULTS
  Of the 71 midvaginal fistulae managed, 40.8% had abdominal repair while the remainder were through vaginal approach. The overall repair success rate was 79.2% with comparable outcome in both groups-78.3% for the abdominal and 80% for the vaginal group (p=0.999). The duration of hospital stay did not differ significantly between the groups (p=0.972). Post operative complications were found in 41.4% of the abdominal group compared to none in the vaginal group (p<0.001). The complications were failed repair (20.7%) and urinary tract infection (20.7%). The mean estimated blood loss was 465.5ml in the abdominal group compared to 332.9ml for the vaginal group (p=0.303).
  
  
  CONCLUSIONS
  Despite the comparable surgical repair outcome of the two methods, the vaginal approach is associated with lesser blood loss and lower risk of post-operative complications. It is recommended that the vaginal route should be employed in the repair of uncomplicated midvaginal fistula unless there are other compelling reasons to the contrary.
authors.affiliation: Dept. of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: I O
authors.initials: IO
authors.lastname: Morhason-Bello
authors.affiliation: Dept. of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: O A
authors.initials: OA
authors.lastname: Ojengbede
authors.affiliation: Dept. of Epidemiology, Medical Statistics, and Environmental, Health, College of Medicine, Ibadan, Oyo State, Nigeria.
authors.forename: B O
authors.initials: BO
authors.lastname: Adedokun
authors.affiliation: Dept. of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: M A
authors.initials: MA
authors.lastname: Okunlola
authors.affiliation: Dept. of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: A
authors.initials: A
authors.lastname: Oladokun
keywords: Mid-vaginal vesico-vaginal fistula; Nigeria; urinary incontinence; vaginal/abdominal surgical methods