Vesicovaginal Fistula at Tertiary Care Center in Eastern Nepal

Uprety, D; Subedi, Sushil; Budhathoki, B.; Regmi, Mohan Chandra

doi:10.31729/jnma.305

Cited by 14 publications

(13 citation statements)

References 5 publications

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“…Given that untreated obstructed labor affects women in many ways and across multiple organ systems [2], which parameters should define a successful outcome? Finally, some avoid the issue altogether by not specifying criteria for success [9]. For other authors, the most important factor is not the anatomic defect, but rather the physiologic problem of incontinence; these writers [6][7][8] define success as dryness or continence after repair.…”

Section: Defining Successmentioning

confidence: 99%

Outcomes in obstetric fistula care

Arrowsmith

Barone

Ruminjo

2013

Current Opinion in Obstetrics &Amp; Gynecology

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Consensus about basic definitions of clinical success does not yet exist. Opinions vary widely about the prognostic parameters for success or failure. Commonly agreed upon definitions and outcome measures will help ensure that site reviews are accurate and conducted fairly. To properly compare technical innovations with existing methods, agreement must be reached on definitions of success. Standardized indicators for mortality and morbidity associated with fistula repair will improve the evidence base and contribute to quality of care.

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Section: Defining Successmentioning

confidence: 99%

Outcomes in obstetric fistula care

Arrowsmith

Barone

Ruminjo

2013

Current Opinion in Obstetrics &Amp; Gynecology

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“…This study showed the teenage pregnancy was not common in our set up contributing 6% of total study group, which is comparable with the study from eastern Nepal. 7 The highest parity in our study was one. Forty three patients (33.9%) had given birth to only one child at the time of presentation.…”

Section: Discussionmentioning

confidence: 45%

“…In the study done in Eastern Nepal it has been reported that, 95.6% Þ stula was due to obstructed labor and 4.4% of gynecological causes. 7 This may be due to the different study region, as in our series, in Kathmandu Model Hospital, there were more number of posthysterectomy Þ stula patients. The age range of the patients in our study was from 10 to 65 years with a mean age of 31.4 years.…”

Section: Discussionmentioning

confidence: 71%

“…5,6 Currently, only few gynecologists have been trained in Nepal to perform Þ stula surgeries at centers like Kathmandu Model Hospital, BPKIHS Dharan and Surkhet Hospital. 7 Thousands of Nepalese women silently suffer from this tragedy of developing world and it is estimated that 200 to 400 new cases of this type Þ stula occur in Nepal each year. 7,8 This study aims to present the status of obstetric and iatrogenic Þ stula surgeries in our institution and their outcome in early phase.…”

Section: Introductionmentioning

confidence: 99%

“…7 Thousands of Nepalese women silently suffer from this tragedy of developing world and it is estimated that 200 to 400 new cases of this type Þ stula occur in Nepal each year. 7,8 This study aims to present the status of obstetric and iatrogenic Þ stula surgeries in our institution and their outcome in early phase.…”

Section: Introductionmentioning

confidence: 99%

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Profile of Obstetric and Iatrogenic Fistula Surgeries at Kathmandu Model Hospital

Shrestha¹,

Karki²,

Dangal³

et al. 2018

Nepal J Obstet Gynaecol

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Aims: Vesico-vaginal Þ stula (VVF) is an abnormal Þ stulous communication between the bladder and/or urethra and the vagina that allows continuous involuntary discharge of urine into the vaginal vault affecting patients' medical, physical, mental, social and sexual life. The aim of this study was to review and deliver a proÞ le, their demography and outcome in the early phase of Þ stula surgery performed in our institute.Methods: This was a retrospective study of 222 patients who underwent Þ stula surgery during the period of January 2012 to March 2018 in Kathmandu Model Hospital. The Þ stula were classiÞ ed according to Goh`s system. Patients' demography, obstetric characteristics and Þ stula repair outcomes were reviewed. The primary outcome was in terms of urinary continence.Results: A total of 222 women aged between 10 to 65 years with a mean age of 31.4 were included. Majority of the patients had Þ stula due to obstetrical cause, contributing 58% (n=127) and in 42 % (n=95) of patients had Þ stula of gynecological etiology. Most of the patients had Þ stula of type 1a, contributing 38% (n=84) and only 0.01% (n=3) of type 3c and 4b according to Goh's classiÞ cation. Among 127 Þ stulas repaired of obstetric etiology100 (78.7%) patients and 85 (89.4%) out of 95 Þ stula patients of gynecological cause were continent and dry.Conclusions: Our study showed obstructed and prolonged labor was the major cause of obstetric Þ stula, however iatrogenic Þ stula was also becoming common. Majority of our cases had successful outcome with some degree of stress in some patients.

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