Abstract

Introduction: Obstetric fistula is the most distressing condition in developing countries due to morbidity and loss of quality of life attributable to it. This study was conducted to determine short term complications and factors associated with these complications after repair the fistula.

Methods: This was descriptive follow up study conducted at Bugando Medical Centre from September 2014 to April 2015 involving 132 women with obstetric fistula and operated at the Centre. Social, demographic and clinical information were collected using questionnaires. Urine samples for culture and sensitivity were collected intra-operatively and data was analyzed using STATA version 11 software.

Results: The median (interquartile range) age of the participants was 23 (20-32) years. The proportion of women who developed short term complications was 42 (31.8%); with predominant complications being failed repair 18 (42.9%) and stress incontinence 10 (23.8%). Asymptomatic bacteriuria was found in 50.8% (33/65) of patients with preponderance of Gram negative bacteria. HIV seropositivity was documented in 4.1% of 123 tested patients and it was significantly associated with short term complications (p=0.002). Moreover, residing in rural areas (p=0.042); median duration of labor for more than 24 hours (p=0.002) with OR (95%CI) 4.38 (1.59 – 13.89), fistula type (p =0.005) and size (p =0.006), reduced bladder capacity (p <0.001) and urethral length (p =0.001) as well as presence of fibrosis (p =0.004) were significantly associated with short term complications among women repaired for obstetric fistulas.

Conclusion: The proportion of women developing short term complications at Bugando Medical Centre is high; with the common complications being failed repair and stress incontinence. The complications were associated with residing in rural areas, HIV seropositivity and fistula characteristics.