The immediate surgical management of fresh obstetric fistulas with catheter and/or early closure

Abstract

Objectives: To determine prospectively if the immediate surgical management of obstetric fistulas within the first 3 months by catheter and/or early closure is effective.

Methods: During a 10-month period (August 1992 through May 1993), a total of 170 patients with an obstetric fistula of less than 3 months' duration were treated. A catheter was inserted if the fistula was necrotic, and as soon as the fistula edge was clean an early closure was performed unless the fistula had healed already.

Results: The fistula was closed in 156 (91.8%) of the 170 consecutive patients: with continence in 146 (93.6%), minimal/mild incontinence in 7 (4.5%) and severe incontinence in 3 (1.9%) of the closed fistulas. In 14 patients (8.2%) the fistula was not closed at first intention; however, 12 were closed at the second attempt.

Conclusion: The immediate surgical management proved highly effective in terms of closure and continence.