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Concept
Obstetric fistula
Summary
Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth. This can be between the vagina and rectum, ureter, or bladder. It can result in incontinence of urine or feces. Complications may include depression, infertility, and social isolation.
Risk factors include obstructed labor, poor access to medical care, malnutrition, and teenage pregnancy. The underlying mechanism is poor blood flow to the affected area for a prolonged period of time. Diagnosis is generally based on symptoms and may be supported by use of methylene blue.
Obstetric fistulae are almost entirely preventable with appropriate use of cesarean section. Treatment is typically by surgery. If treated early, the use of a urinary catheter may help with healing. Counseling may also be useful. An estimated 2 million people in sub-Saharan Africa, Asia, the Arab region, and Latin America have the condition, with about 75,000 new cases developing a year. It occurs very rarely in the developed world and is considered a disease of poverty.
Symptoms of obstetric fistula include:
Flatulence, urinary incontinence, or fecal incontinence, which may be continual or only happen at night
Foul-smelling vaginal discharge
Repeated vaginal or urinary tract infections
Irritation or pain in the vagina or surrounding areas
Pain during sexual activity
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 to walk, infection of the fistula forming an abscess, and up to two-thirds of sufferers 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 parent is left with chronic incontinence.
Official source
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