INTERNATIONAL DAY TO END OBSTETRIC FISTULA

International Day to End Obstetric Fistula is celebrated on 23rd May every year. It is a day set by the United Nations to significantly raise awareness and intensify actions towards ending Obstetric Fistula as well as to restore the health of those affected by it. It is common in developing countries especially in sub Saharan Africa example Nigeria. According to WHO, an estimated number of 50,000 to 100,000 women develop Obstetric Fistula each year and over 2 Million women currently live with it. In Nigeria, there is a prevalence of 3.2 cases per 1000 births and it is estimated that about 13,000 new cases occur annually, suggesting the backlog of unrepaired cases. 

WHAT IS OBSTETRIC FISTULA?

It is defined as an abnormal opening between a woman’s genital tract and the urinary bladder or rectum caused by prolonged obstructed labor without treatment. It is one of the most serious and tragic child birth injuries. It leaves women with urine and fecal incontinence problems and often leads to chronic medical issues, depression, social isolation, loss of self-esteem, and psychological problems such as suicide. 

CAUSES OF OBSTETRIC FISTULA

90% of obstetric fistula is caused by prolonged and obstructed labour. Other factors include;

1. Early pregnancy: Women suffering from fistula had become pregnant between the ages of 15-18. The small pelvic size of these girls can be a causative factor. 
2. Harmful traditional practices such as female genital cutting. In Africa. 15% of fistula formation is as a result of harmful genital cutting by unskilled attendants. 

TYPES OF OBSTETRIC FISTULA

1. Vesicovaginal Fistula (VVF): abnormal communication between the bladder and vagina.
2. Urethrovaginal Fistula (UVF): abnormal communication between the urethra and vagina.
3. Rectovaginal Fistula (RVF): abnormal communication between the rectum and the vagina.
4. Ureterovaginal Fistula: abnormal communication between the ureters and the vagina.

SYMPTOMS OF OBSTETRIC FISTULA

1. Constant urine leakage/fecal incontinence.
2. irritation of the skin around the vulva/vagina.
3. Recurrent urinary tract infection.
4. Foul smelling vagina discharge. 
5. Painful sexual intercourse.
6. Ulceration of the vagina.

PREVENTION OF OBSTETRIC FISTULA

1. Girl child education on sexual and reproductive health.
2. Access to family planning/contraception.
3. Ensure the pregnancies are planned, wanted, and occur at an optimal time in a woman’s life.
4. Cessation of harmful traditional practices.

TREATMENT OF OBSTETRIC FISTULA

1. Counselling.
2. Urinary catherization may help with healing if detected early.
3. It can be closed with reconstructive surgery if it is performed early by a skilled surgeon.

Written By Dr. Stephanie

Edited by Hakeem