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RMJ. 2019; 44(4): 709-712


Factors responsible for Iatrogenic Genito-urinary fistula in women

Ambreen Amna, Farkhunda Nadeem, Amin Fahim, Altaf Hussian Jotoi, Pushpa Srichand, Kanwal Abbas.

Abstract
Objective: To determine the frequency and etiological factors of iatrogenic fistula (IF) in women presenting with incontinence at Isra University Hospital, Hyderabad.
Methodology: This descriptive study was conducted at fistula center, Isra University Hospital, Hyderabad from January 2017 to December 2018. Women with genitourinary fistula (GIF) either admitted or treated at the Isra Fistula center were studied. Women presenting with urinary incontinence after major Gynecological and Obstetrical surgeries were included whereas women with stress incontinence, urge incontinence and women with neurogenic bladder were excluded. All were evaluated by detailed history, physical examination, relevant investigations and examination under general anesthesia (EUA). Repair was done based on findings of EUA. Results of repair were noted and analyzed using SPSS version 16.
Results: Out of 96 cases, 56(58.33%) were iatrogenic, while 40(41.66%) were due to obstructed labor. The success rate for repair was 92%.
Conclusion: There is rising trend in iatrogenic fistula. There should be increased awareness regarding gynecological surgeries among newly graduate doctors so that health care provider have improved surgical skills regarding safe hysterectomy.

Key words: Vesicovaginal fistula, Obstructed labour, Hysterectomy, Iatrogenic fistula.


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