Management of Obstetric Fistula at Bugando Medical Centre.
Dafa, Omary. Mkomwa CUHAS/MD/4001162/T/14
Management of Obstetric Fistula at Bugando Medical Centre. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] : ©2019 - ix; 57 Pages Includes References
Background: Obstetric fistula (OF) is a severe condition which has devastating consequences for woman’s life. The estimation of the burden of fistula at the population level has been impaired by the rarity of diagnosis and lack of rigorous studies (1). The World Health Organization defines an Obstetric fistula as an abnormal opening between a woman’s vagina and bladder and/or rectum through which her urine and/or feaces continually leak (2). Classification of fistula vary, but they generally include fistulae from obstetric causes including vesicovaginal fistula (VVF) and rectovaginal fistulae (RVF). Fistulae have devastating consequences (1), particularly in low income countries where women have less geographical and financial access to appropriate surgical care for repair. In high income countries they are also devastating, but they are very rare and surgery to repair them occurs more rapidly.
In high countries, fistulae are due to iatrogenic causes, generally the results of radiation therapy and surgical interventions. In low income countries where access to intrapartum care may be restricted, fistulae are associated with a prolonged or obstructed labour, most commonly occurring when a baby’s head becomes lodged in the mother’s pelvis cutting off blood flow to the surrounding tissues(3).
Women with fistulae often experiences horrific or difficult associated conditions which stem either from the fistulae itself or from the prolonged or obstructed which caused it (1). The most obvious consequences are incontinence, either urinary (1). Faecal or both. The constant leakage of urine or feaces can also lead to damage to the vulva or thighs (3). Fistulae are linked with social ostracisation and marginalization. Many case series show high rates of divorce or separation (3), absence of sexual intercourse (3), loss of fertility and amenorrhea (4) and depression (5) among women who have fistula.
The WHO estimates that more than 2 million young women throughout the world live with untreated fistula, and that between 50,000 and 100,000 new women are affected each year.
General objectives: The management of obstetric fistula patients at Bugando medical centre (BMC).
Specific objectives: The following are the specific objectives of my study:
To learn how fistula are evaluated pre-operative.
To learn principles of surgical treatment of obstetric fistula.
To learn post-operative care of obstetric fistula
To learn the follow up after management of obstetric fistula
To determine the causes of obstetric fistula
To learn and gain experience on medications, investigations and management of obstetric fistula.
To know the different methods of preventions of obstetric fistula.
Rationale of the study
Obstetrics fistula (Vesicovaginal fistula) secondary to obstructed continues to be an all too common occurrence in underdeveloped nations throughout Africa and Asia. Vesicovaginal fistula remains largely and overlooked problem in developing nations as it affects the most marginalized members of society, young poor, illiterate women who live in remote areas.
So the obstetric fistula is a global health care problem, predominantly associated with obstetric complications in low-resourced countries and iatrogenic injury in well-resourced countries.
It is estimated that more than 2 million women are living with obstetric fistulas (OFs) worldwide, particularly in Africa and Asia, and yet this severe morbidity remains hidden. As a contribution to the global campaign of end fistula, the world health organization (WHO) published obstetric fistula guiding principles for clinical management and programme of obstetric fistula, principles that will guide them to develop strategies and programs to prevent and treat obstetric fistulas (OF), and assist health professionals as they acquire better skills and develop more effective services to care for women treated for fistula repair (2).
So many aim of this attachment is to able to know the risk factors, to know the proper management of the obstetric fistula and obstetric fistula associated complications so as to reduce maternal morbidity and other complications associated with obstetric fistula.
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O. Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : www.bugando.ac.tz
--Obstetrics and Gynecology
Management of Obstetric Fistula at Bugando Medical Centre. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] : ©2019 - ix; 57 Pages Includes References
Background: Obstetric fistula (OF) is a severe condition which has devastating consequences for woman’s life. The estimation of the burden of fistula at the population level has been impaired by the rarity of diagnosis and lack of rigorous studies (1). The World Health Organization defines an Obstetric fistula as an abnormal opening between a woman’s vagina and bladder and/or rectum through which her urine and/or feaces continually leak (2). Classification of fistula vary, but they generally include fistulae from obstetric causes including vesicovaginal fistula (VVF) and rectovaginal fistulae (RVF). Fistulae have devastating consequences (1), particularly in low income countries where women have less geographical and financial access to appropriate surgical care for repair. In high income countries they are also devastating, but they are very rare and surgery to repair them occurs more rapidly.
In high countries, fistulae are due to iatrogenic causes, generally the results of radiation therapy and surgical interventions. In low income countries where access to intrapartum care may be restricted, fistulae are associated with a prolonged or obstructed labour, most commonly occurring when a baby’s head becomes lodged in the mother’s pelvis cutting off blood flow to the surrounding tissues(3).
Women with fistulae often experiences horrific or difficult associated conditions which stem either from the fistulae itself or from the prolonged or obstructed which caused it (1). The most obvious consequences are incontinence, either urinary (1). Faecal or both. The constant leakage of urine or feaces can also lead to damage to the vulva or thighs (3). Fistulae are linked with social ostracisation and marginalization. Many case series show high rates of divorce or separation (3), absence of sexual intercourse (3), loss of fertility and amenorrhea (4) and depression (5) among women who have fistula.
The WHO estimates that more than 2 million young women throughout the world live with untreated fistula, and that between 50,000 and 100,000 new women are affected each year.
General objectives: The management of obstetric fistula patients at Bugando medical centre (BMC).
Specific objectives: The following are the specific objectives of my study:
To learn how fistula are evaluated pre-operative.
To learn principles of surgical treatment of obstetric fistula.
To learn post-operative care of obstetric fistula
To learn the follow up after management of obstetric fistula
To determine the causes of obstetric fistula
To learn and gain experience on medications, investigations and management of obstetric fistula.
To know the different methods of preventions of obstetric fistula.
Rationale of the study
Obstetrics fistula (Vesicovaginal fistula) secondary to obstructed continues to be an all too common occurrence in underdeveloped nations throughout Africa and Asia. Vesicovaginal fistula remains largely and overlooked problem in developing nations as it affects the most marginalized members of society, young poor, illiterate women who live in remote areas.
So the obstetric fistula is a global health care problem, predominantly associated with obstetric complications in low-resourced countries and iatrogenic injury in well-resourced countries.
It is estimated that more than 2 million women are living with obstetric fistulas (OFs) worldwide, particularly in Africa and Asia, and yet this severe morbidity remains hidden. As a contribution to the global campaign of end fistula, the world health organization (WHO) published obstetric fistula guiding principles for clinical management and programme of obstetric fistula, principles that will guide them to develop strategies and programs to prevent and treat obstetric fistulas (OF), and assist health professionals as they acquire better skills and develop more effective services to care for women treated for fistula repair (2).
So many aim of this attachment is to able to know the risk factors, to know the proper management of the obstetric fistula and obstetric fistula associated complications so as to reduce maternal morbidity and other complications associated with obstetric fistula.
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O. Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : www.bugando.ac.tz
--Obstetrics and Gynecology