The burden of vesico-vaginal fistula in north central Nigeria.

Background: Vesico Vaginal Fistula (VVF), as seen in this environment, is a major cause of severe morbidity and potential mortality, which can result in marital disruption, rejection and, eventual destitution.

Aims And Objectives: To determine the socio-demographic characteristics, fistula features, and evaluate the intervention measures in Jos, North Central Nigeria.

Setting: This study was carried out at the VVF Centre, ECWA Evangel Hospital, Jos, North Central Nigeria.

Design Of The Study: Descriptive retrospective study.

Materials And Methods: The patients' records from January 1 to December 31, 2007 were retrieved and analyzed for the demographics, clinical features, management and outcome using EPI Info version 3.4.3, 2008.

Results: A total of 314 patients were treated. The patients aged between 12 to 60 years (SD 6.19) with a mean parity of 3.7. Seventy percent (70%) of the patients were married and living with their husbands, while 65% of the patients were illiterate farmers. Christians and Muslims patients made up 60% and 40% respectively. Juxta-cervical (26%) and juxta-urethral fistulae (26%) were the commonest types, with obstructed labour being the causative factor in 82% of the patients. Ninety three percent of the repairs were repaired via the vaginal approach. The success rate at repair was 69%. Post-operative complications occurred in 16% of the patients.

Conclusion: Vesico- vaginal fistula is a problem in this environment, occurring mainly amongst the illiterate farmers after prolonged obstructed labour. Public enlightenment and appropriate ante-natal care and delivery would reduce the incidence.