Prevalence, profile and obstetric experience of fistula patients in Abakaliki, Southeast Nigeria

Objective. Fistula has always been thought to be a scourge of the Northern region of Nigeria only. This study was aimed at providing data on the prevalence, profile and obstetric experience of fistula patients in Abakaliki, Southeast Nigeria and to demonstrate that fistula is also a burden in the southern parts of Nigeria. Materials and Methods. This was a prospective descriptive study conducted between 2003 and 2009. Sample size and sampling method. Four hundred and sixty-two fistula patients who were operated at the Fistula Unit of the Teaching Hospital and later at the Southeast Fistula Centre was consecutively recruited and interviewed during the study period. Results. The prevalence of fistula was 4.3%, the mean age was 35±9.5 years and 8.4% was less than 20 years, majority of them had no formal education. A quarter had no occupation and majority had no regular monthly income. Twenty percent were married by the age of 14 years and majority were multiparous. In about 40%, the fistula occurred during the first child birth. About 34% were still sexually active and 30% of the married clients had achieved childbirth after development of fistula. The average height and weight were 1.47m±0.08 and 46.4kg±7.2 respectively. Majority had fistula following prolonged obstructed labour, though 42.6% eventually had caesarean section for prolonged obstructed labour. Majority of the patients were older, had a longer urine leakage and presented latter for corrective surgery than those reported from other parts of Nigeria. Conclusions. There is a high prevalence (43.6/1000 deliveries) of obstetric fistula in this Centre, and majority of the vesico-vaginal fistula (VVF) was due to prolonged obstructed labour. Majority of the patients were older, had a longer urine leakage and presented latter for corrective surgery than those reported from other parts of Nigeria. However, 30% of the married patients achieved a pregnancy and delivered vaginally even in the presence of the fistula.