Published in:
01-02-2019 | Original Article
Profile and outcome of patients with recurrent urogenital fistula in a fistula centre in Nigeria
Published in: International Urogynecology Journal | Issue 2/2019
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Introduction and hypothesis
Management of a recurrent urogenital fistula is very challenging and requires experienced surgeons. The aim of this study was to describe the characteristics, success rates, and associated factors related to surgical repairs of patients with recurrent urogenital fistulas by an experienced team at a fistula centre in Nigeria.
Methods
This was a retrospective cohort study of 154 patients that had repeat urogenital fistula repairs at the National Obstetric Fistula Centre, Abakaliki, Nigeria, between January 2014 and December 2016. Information was retrieved from their hospital records. Successful repair was defined by continent status at 3 months after repair. Data were analyzed with SPSS version 20 by IBM Inc., and p < 0.05 was taken as statistically significant. Chi-square test was used to determine the association between the factors and successful repair.
Results
The mean age was 36.27 ± 12.96 years. Obstetric fistula occurred in 92.2% of the patients. The success rates for the first, second, third, and fourth repeat repairs were 68.8%. 56.2%, 50%, and 0% respectively. Significant factors were the number of previous attempts at repair (χ2 = 20.44, p = 0.002), age group (χ2 = 16.95, p = 0.03), Waaldijk’s classification (χ2 = 13.31, p = 0.04), duration of fistula (χ2 = 19.6, p = 0.03), surgeons’ experience (χ2 = 7.11, p = 0.04), and place of previous attempt at repair (χ2 = 6.35, p = 0.02). There were no complications in 86.4%.
Conclusions
The success rate was good. Patients who had previous failed repairs at the fistula centre had better outcomes after the repeat surgeries. Centralizing fistula care will enhance optimal outcomes. It may also boost training and research in this specialty.