Objective Vesico-vaginal fistula (VVF) involves the pathological communication between the urinary bladder and vagina, possible complications arising from urinary tract infection merits consideration. This study seeks to evaluate significant bacteriuria among VVF clients. SettingThe setting was the South east Fistula Centre, Abakaliki, Ebonyi State, Nigeria. PopulationThis was a total population study of all consenting HIV negative VVF clients. MethodThis cross-sectional study assessing asymptomatic bacteriuria was conducted among 109 HIV negative VVF clients using standard microbiological technique. Haematological and anthropometric parameters were also assessed. ResultsThe prevalence of asymptomatic bacteriuria was 76.1% and the highest prevalence was among clients aged 21-30years (90.3%), those who have had more than seven deliveries (85.0%) and those whose labour duration lasted above 48hours (76.7%). The prevalence of bacteriuria was least among women with VVF for less than a year. The prevalence was highest among patients with intra cervical fistula (83.3%). Bacteriuria prevalence was highest among women of blood group AB (100%). The rate was higher among women whose heights were > 1.53metres and whose weights were < 51kilogram. Six different bacterial species isolated include E. coli (41.0%), Proteus species (21.7%), and Klebsiella species (18.1%). Though the bacterial isolates were resistance to many of the antibiotics assessed, the highest level of resistance was observed with perfloxacin, cotrimoxazole, while the highest level of susceptibility was with Ciprofloxacin. ConclusionThe prevalence of bacteriuria in this study is rather high and should not be neglected in the management of VVF clients.

Background: Vesicouterine fistula is a rare type of genital fistula. It is a cause of urinary incontinence in our environment. It usually results from caesarean section. The study was undertaken to document our experience in the management of this condition.Methodology: This is a retrospective study carried out at the National Obstetric Fistula Centre, Abakaliki, Nigeria from January 2013 to October 2015. Records of women with vesicouterine fistula were retrieved. Information on age, parity, predisposing factors, aetiology, presentation, diagnosis, management and outcomes of repair were obtained. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 20.Results: Vesicouterine fistula was seen in 13 out of 619 women constituting 2.1% of all genital fistulas. The mean age of the women was 37.4 ± 9.9 years with 53.5% of them between 30-39 years. Of the 12 women who had term pregnancies, 3 (25%) had no previous caesarean section, 4 (33.3%) had 1 previous caesarean section and 5 (41.7%) had 2 previous caesarean sections making previous caesarean section a predisposing factor in 75% of cases. Fistula occurred following caesarean section in 7 women (53.8%), vaginal delivery in 4 (30.8%), exploratory laparotomy due to uterine rupture in 1 (7.7%) and dilatation and curettage in 1 (7.7%). All 4 women whose fistula followed vaginal delivery had previous caesarean section. All the 13 women presented with menouria. Two (15.4%) had menouria only while11 (84.6%) had menouria with urinary incontinence. In 6 women (46.2%), diagnosis was clinical. Hysterosalpingogram was employed in 1 patient. All the women had surgical repair via the retropubic extraperitoneal approach. Fistula was closed in all 13 women. Conclusion:Vesicouterine fistula is uncommon and usually follows caesarean section. Previous caesarean section is an important predisposing factor. It presents commonly as menouria and urinary incontinence. Outcomes of repair are excellent.

Background: Neurofibromatosis type 1 is an autosomal dominant transmitted disease with various forms of clinical presentation. It commonly affects the skin and the nervous system. Involvement of the genitourinary system is rare. The bladder is the most commonly affected organ in the urinary system. Vesicovaginal fistula presenting as continuous leakage of urine per vagina is a rare urogenital manifestation of neurofibromatosis which has not been previously reported to the best of our knowledge. Vesicovaginal fistula is not a usual complication of urethral catheterization. Our aim is to report a rare case of vesicovaginal fistula in a patient with neurofibromatosis.

Objective: Vesico-vaginal fistula (VVF) may co-exist with bladder calculi. Traditionally, management entails removal of the calculus and deferment of fistula repair. The study aims to present our findings in the management of women with this combination.Methodology: This is a retrospective review of twenty-three women with vesico-vaginal fistula and bladder calculi managed from December 2008 to June 2014 at the National Obstetric Fistula Centre, Abakaliki, Nigeria. The case history, physical findings, investigation results, operation notes and follow-up notes of twenty women were available and form the basis of this review. Results:The prevalence of bladder calculi among vesico-vaginal fistula patients was 1.45%. Most of the bladder calculi were removed via the transvaginal route. In majority of cases (55%), removal of the calculi and repair of the fistula were performed at the same sitting. Ninety-five percent of the patients had successful repair. Conclusion:These findings suggest that the co-existence of bladder calculi and vesico-vaginal fistula is uncommon. Clinical diagnosis is usually sufficient. Fistula repair could safely be undertaken at the same sitting with removal of the calculus in well-selected cases suggesting a paradigm shift in the management of this combination.