Genital fistula: Successes, challenges, and way forward in a facility specialization in fistula management in Bangladesh

  • Nrinmoy Biswas Hope Hospital, Ramu, Cox’s Bazar http://orcid.org/0000-0002-3319-5516
  • Iftikher Mahmood Hope Hospital, Ramu, Cox’s Bazar
  • Sathyanarayan Doraiswamy United Nations Population Fund (UNFPA), Bangladesh
  • Animesh Biswas United Nations Population Fund (UNFPA), Bangladesh

Abstract

Aims: To explore the prevalence, types of genital fistulas as well as their success, challenges, and way forward on genital fistula in Bangladesh.

Methods: Between October 2017 and September 2018, Hope Hospital identified a total number of 101 genital fistula cases though a community network system in Cox’s Bazar. For each of the patients, detailed case histories and clinical management reports documented, and the data were interpreted using descriptive analysis.

Results: Out of 101 genital fistula cases admitted to the facility, 95.3% (n=96) of cases were obstetric; three cases iatrogenic, and one each traumatic and congenital. The median age of the women was 28 years (range: 18 -73) and the median duration of two years (range: 1 month-53 years). Most of the cases had urinary incontinence (86.1 %, n=85) and 12 and two cases were fecal and mixed type respectively. Vesicovaginal fistula (VVF) repair was performed in most of the cases (78.2%, n=79) while 21.8% (n=22) received recto vaginal fistula (RVF) repair. 90% (n=91) were discharged without complication. The median duration of hospital stay was 16 days (range: 4 -29). The success rate was 86.1% (n=85), and 16 cases advised for repeat surgery. Pre-and post-surgery counselling was provided without rehabilitation or reintegration support.

Conclusions: Facility data in a particular geographic location represents high prevalence of obstetric fistula and lacks rehabilitation and social reintegration support. Further study is essential to draw a complete geographical map for genital fistula in Bangladesh.

Keywords: genital fistula, management, rehabilitation, Bangladesh

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Author Biography

Nrinmoy Biswas, Hope Hospital, Ramu, Cox’s Bazar

Department of Obstetrics and Gynaecology

Published
2019-12-09
How to Cite
Biswas, N., Mahmood, I., Doraiswamy, S., & Biswas, A. (2019). Genital fistula: Successes, challenges, and way forward in a facility specialization in fistula management in Bangladesh. Nepal Journal of Obstetrics and Gynaecology, 14(1), 19-23. https://doi.org/10.3126/njog.v14i1.26622
Section
Original Articles