title: Circumferential urethral fistulae in Sub-Saharan Africa, current outcomes and future prospects.
abstract: OBJECTIVE
  Circumferential urethral fistula is a severe form of obstetric injury that is recognized to carry a poor prognosis for eventual continence but this has not been quantified before.
  
  
  METHODS
  An analysis of 106 women who had undergone primary repair of a circumferential fistula was carried out with particular reference to whether there complete continence or at least some improvement in remaining dry was reported.
  
  
  RESULTS
  Of the 106 women, only 25% reported themselves continent; 19% said there was an improvement. Prognosis was not altered by the distance of the fistula from the external urethral meatus, with 10/62 (16% reporting continence if the fistula was <1.5 cm and 10/44 (13%) if >1.5 cm. There was a 13% primary dehiscence rate.
  
  
  CONCLUSIONS
  Current methods of primary urethral fiistula repair carry a poor prognosis for eventual continence. Techniques to lengthen the urethra and provide greater support need to be developed for this unfortunate group of women.
authors: Hamlin Fistula Ethiopia and Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK, Jeremy.wright@surrey.ac.uk.
authors: Jeremy
authors: J
authors: Wright
mesh_terms: D005002:Ethiopia; D005260:Female; D006801:Humans; D012003:Rectal Fistula / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000601:surgery; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D014548:Urinary Fistula / Q000150:complications / Q000473:pathology / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D014624:Vaginal Fistula / Q000150:complications / Q000601:surgery*