title: Sexual activity among Nigerian women following successful obstetric fistula repair.
abstract: OBJECTIVE
  To evaluate post-operative sexual activity among women who have undergone obstetric fistula repair.
  
  
  METHODS
  The present descriptive cross-sectional study recruited married women who had undergone successful obstetric fistula repair who were attending reunion activities at Bingham University Teaching Hospital, Jos, Nigeria, between March 13 and March 15, 2014. Participants were interviewed regarding penetrative vaginal intercourse after surgery, and any changes in sexual desire, arousal, orgasm, sexual satisfaction, and the presence of coital pain compared with before they experienced obstetric fistula.
  
  
  RESULTS
  There were 102 patients who participated in interviews; 23 (22.5%) reported not being able to engage in penetrative vaginal intercourse and 12 (52%) of these patients ascribed this to a "tight" or "narrow" vagina. Compared with the pre-fistula period, 63 (61.7%) patients reported reduced sexual desire, 57 (55.9%) reported lack of or inadequate lubrication during intercourse, 12 (11.8%) reported anorgasmia, and 60 (58.8%) reported reduced attainment of orgasm. Dyspareunia was reported by 48 (47.1%) patients; 43 (90%) experienced superficial or deep dyspareunia, and 5 (10%) experienced both. A lack of and lower sexual satisfaction were reported by 20 (19.6%) and 40 (39.2%) patients, respectively.
  
  
  CONCLUSIONS
  Following obstetric fistula repair, many women experienced difficulty engaging in penetrative vaginal intercourse and reported sexual dysfunction. Management of sexual dysfunction should be part of fistula rehabilitation programs.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, Bingham University, Karu, Jos campus, Jos, Nigeria.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Anzaku
authors.affiliation: Department of Family Medicine, College of Medicine and Health Sciences, Bingham University, Karu, Jos campus, Jos, Nigeria.
authors.forename: Sunday J
authors.initials: SJ
authors.lastname: Lengmang
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, Bingham University, Karu, Jos campus, Jos, Nigeria.
authors.forename: Samaila
authors.initials: S
authors.lastname: Mikah
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, Bingham University, Karu, Jos campus, Jos, Nigeria.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Shephard
authors.affiliation: Department of Anesthesia and Intensive care, College of Health Sciences, Benue State University, Makurdi, Nigeria.
authors.forename: Bassey E
authors.initials: BE
authors.lastname: Edem
mesh_terms: D000328:Adult; D003075:Coitus; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D009549:Nigeria; D011184:Postoperative Period; D011788:Quality of Life; D012006:Rectovaginal Fistula / Q000601:surgery*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014719:Vesicovaginal Fistula / Q000601:surgery*; D055815:Young Adult
keywords: Nigeria; Obstetric fistula; Sexual dysfunction; Sexual life