Vesicovaginal fistula: what is the preferred closure technique?

Excerpt

Vesicovaginal fistula (VVF) is a worldwide problem; however, the true incidence and prevalence is not known. Reportedly affecting as many as two million women, this number reflects an estimate from an expert opinion, without the benefit of national or regional “interview and exam” prevalence data [1]. In most settings where obstetric fistula presents an ongoing public health problem, fistula incidence is extrapolated from maternal mortality estimates (as high as 1:7 in impoverished settings compared to 1:4,000 in industrialized nations) if calculated at all. Accurate global prevalence data are difficult to collect, particularly in global regions with poor infrastructure and large populations living in remote rural settings where obstetric fistula is most common. …