Vaginal fistula
| Obstetric fistula | |
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| Areas where obstetric fistulae commonly occur | |
| Specialty | urology |
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Obstetric fistula is a medical condition in which a hole develops between either the rectum and vagina (see rectovaginal fistula), a ureter and the vagina, or between the bladder and vagina (see vesicovaginal fistula) after difficulties in childbirth. It can result in incontinence of urine or feces.
In developed countries, the majority of women with OF have rectovaginal fistula (RVF). This injury is associated with episiotomy and forceps/vacuum extraction of the baby from the vagina. Over 80% of RVFs in the USA are obstetric and either preventable or treatable, followed in frequency by Crohn's disease and radiation. An obstetric fistula is almost entirely preventable. According to health advocates, its persistence is a sign that health systems are failing to meet women’s essential needs.
It is more common when adequate medical care is not available. It is considered a disease of poverty. An estimated 2 million women in sub-Saharan Africa, Asia, the Arab region, and Latin America and the Caribbean are living with this injury, and some 50,000 to 100,000 new cases develop each year.
Symptoms of obstetric fistula include:
Other effects of obstetric fistulae include stillborn babies due to prolonged labor, which happens 85% to 100% of the time, severe ulcerations of the vaginal tract, "foot drop", which is the paralysis of the lower limbs caused by nerve damage, making it impossible for women to walk, infection of the fistula forming an abscess, and up to two-thirds of the women become amenorrhoeic.
Obstetric fistulae have far-reaching physical, social, economic, and psychological consequences for the women affected.
According to UNFPA, “Due to the prolonged obstructed labour, the baby almost inevitably dies, and the woman is left with chronic incontinence. Unable to control the flow of urine or faeces, or both, she may be abandoned by her husband and family and ostracized by her community. Without treatment, her prospects for work and family life are virtually non-existent.”
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Wikipedia