Please enter verification code
Obstetric Vesico-vaginal Fistulae: A Documentary Review of Women Managed in Mendefera Zonal Referral and National Fistula Hospital, Eritrea
Science Journal of Public Health
Volume 8, Issue 5, September 2020, Pages: 149-154
Received: Jul. 9, 2020; Accepted: Aug. 4, 2020; Published: Oct. 7, 2020
Views 98      Downloads 37
Dawit Sereke, Department of Obstetrics and Gynecology, Mendefera Zonal Referral and National Fistula Hospital, Mendefera, Eritrea
Habte Hailemelecot, Department of Obstetrics and Gynecology, Mendefera Zonal Referral and National Fistula Hospital, Mendefera, Eritrea
Yirgalem Issak, Department of Obstetrics and Gynecology, Mendefera Zonal Referral and National Fistula Hospital, Mendefera, Eritrea
Dawit Estifanose, Department of Obstetrics and Gynecology Orotta National Referral Maternity Hospital, Asmara, Eritrea
Article Tools
Follow on us
Background: obstetric fistula is a devastating childbirth injury as a result of obstructed labor. It leads to chronic urinary incontinence and, in most cases, significant physical and emotional suffering. Its prevalence is high in Sab-Sahara African and South Asian countries. The objective of this study is to determine the incidence and describe the characteristics of women with obstetric Vesico-vaginal fistula. Methods: A retrospective cross-sectional study was conducted in all obstetric vesico-vaginal fistula patients. Patient identification performed through review of prerecorded logbook and patient card describing each patient admitted to fistula ward over a period of five years from January 1st 2014 to December 31, 2018. Medical records were reviewed to obtain data on socio-demographic and obstetric characteristics, clinical details, and treatment. Statistical analysis was performed using STATA-9. Results: There were 146 women with Vesico-vaginal fistula (VVF) admitted to the fistula hospital over the study period; of which 144 of them were obstetric fistula. During the study period the total number of health facility deliveries in Eritrea was 217,119 giving an estimated rate of obstetric VVF of 0.7/1000 facility deliveries. The median age, parity, and number of live births was 30, 3, and 2, respectively. One quarter (n=37) of the cases being in the age group of 20years or younger. The highest incidence of VVF (38%) was observed in Primiparous. 75% gave birth in a health facility, 54% of deliveries were by caesarean section, and 80% of babies were stillborn. 77% of repairs were successful. Conclusion: The incidence of fistula in Eritrea is relatively low as compared to other sub-Saharan African countries. In this study, age at fistula development was older than usually found, which might be due to poor access to emergency obstetric care (EmOC) that contributed more to this problem.
Incidence, Obstetric Fistula, Vesico-vaginal Fistula
To cite this article
Dawit Sereke, Habte Hailemelecot, Yirgalem Issak, Dawit Estifanose, Obstetric Vesico-vaginal Fistulae: A Documentary Review of Women Managed in Mendefera Zonal Referral and National Fistula Hospital, Eritrea, Science Journal of Public Health. Vol. 8, No. 5, 2020, pp. 149-154. doi: 10.11648/j.sjph.20200805.13
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ahmed. S, Tunçalp Ö. Burden of obstetric fistula: From measurement to action. The Lancet Global Health- May 2015. DOI: 10.1016/S2214-109X(15)70105-1.
Integrated Management of Pregnancy and Childbirth: Obstetric Fistula: Guiding principles for clinical management and programme development. World Health Organization 2006.
Hilton P, Vesico-vaginal fistulas in developing countries. International Journal of Gynecology and Obstetrics 82 (2003) 285-295. Doi: 10.1016/s0020-7292(03)0022-4.
Bimbola et al. Obstructed Labour: The Main Cause of Vesico-Vaginal Fistula – Review of Literature. European Journal of Research in Medical Sciences Vol. 1 No. 1 September 2013.
Tebeu PM et al. Risk factors for obstetric fistula: a clinical review. Int Urogynecol J. 2012; 23 (4): 387–94. DOI 10.1007/s00192-011-1622-x.
Maheu-Giroux et al. Risk factors for vaginal fistula symptoms in Sub-Saharan Africa: a pooled analysis of national household survey data. BMC Pregnancy and Childbirth BMC series – open, inclusive and trusted 2016, 16: 82. DOI: 10.1186/s12884-016-0871-6.
Adler AJ et al. Estimating the prevalence of obstetric fistula: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013; 13: 246.
Tunçalp Ö, Tripathi V, Landry E, Stanton K, Ahmed S. Measuring the incidence and prevalence of obstetric fistula: approaches, needs and recommendations. Bull World Health Organ. 2015; 93: 60–2. doi:
Danso K, Martey J, Wall L, Elkins T. The epidemiology of genitourinary fistulae in Kumasi, Ghana, 1977–1992. Int Urogynecol J Pelvic Floor Dysfunct 1996; 7: 117–120. doi: 10.1007/BF01894198.
Muleta M, Rasmussen S, Kiserud T. Obstetric fistula in 14,928 Ethiopian women. Acta Obstet Gynecol Scand. 2010; 89 (7): 945–51.
Stanton C, Holtz SA, Ahmed S. Challenges in measuring obstetric fistula. Int J Gynaecol Obstet. 2007; 99 Suppl 1:S4–9. pmid: 17765240}.
Muleta M. Obstetric Fistula in Developing Countries: A Review Article. J Obstet Gynaecol Can 2006; 28 (11): 962–966.
Umeora OUJ, Emma-Echiegu NB (2015) Vesico-Vaginal Fistula in Developing Countries - Time to Turn off The Tap. J Preg Child Health 2:e120. doi: 10.4172.
Hinrichsen, D. Obstetric Fistula: Ending the Silence, Easing the Suffering. INFO Reports, No. 2. Baltimore, Johns Hopkins Bloomberg School of Public Health, The INFO Project, Sept. 2004).
Karen D. Cowgill, Jennifer Bishop, Amanda K. Norgaard, Craig E. Rubens and Michael G. Gravett. Obstetric fistula in low-resource countries: an under-valued and under-studied problem – systematic review of its incidence, prevalence, and association with stillbirth. BMC Pregnancy and Childbirth 201515: 193. DOI: 10.1186/s12884-015-0592-2.
Maheu-Giroux M et al. Prevalence of symptoms of vaginal fistula in 19 sub-Saharan Africa countries: a meta-analysis of national household survey data. Lancet Glob Health. 2015; 3 (5): e271–8.
M. Stamatakos, C. Sargedi, T. Stasinou & K. Kontzoglou. Vesicovaginal Fistula: Diagnosis and Management, Indian J Surg (March–April 2014) 76 (2): 131–136 DOI 10.1007/s12262-012-0787-y.
Holme A, Breen M, MacArthur C (2007). Obstetric fistulae: a study of women managed at the Monze Mission Hospital, Zambia. BJOG2007; 114: 1010–1017. DOI: 10.1111/j.1471-0528.2007.01353.x.
National Statistics Office (NSO) [Eritrea] and Fafo AIS. 2013. Eritrea Population and Health Survey 2010.
HMIS Eritrean Ministry of Health 2018 Annual Report.
Wall, LL. Obstetric vesicovaginal fistula as an international public-health problem. Lancet 2006; 368: 1201.
Raassen, T. J., E. G. Verdaasdonk, and M. E. Vierhout. 2008. “Prospective Results after First-Time Surgery for Obstetric Fistulas in East African Women.” International Urogynecology Journal 19 (1): 73–79.
Mary Lake Polan, Ambereen Sleemi, Mulu Muleta Bedane, Svjetlana Lozo, and Mark A Morgan, Obstetric Fistula. Essential Surgery: Disease Control Priorities, Third Edition (Volume 1): 95-108.
Demisew Anemu Sori, Ahadu Workineh Azale, and Desta Hiko Gemeda, Characteristics and repair outcome of patients with Vesicovaginal fistula managed in Jimma University teaching Hospital, Ethiopia. BMC Urol. 2016; 16: 41. Published online 2016 Jul 12. doi: 10.1186/s12894-016-0152-8.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186