Abstract:
Introduction Repair of obstetric urinary fistula may result in
successful fistula closure, but often incontinence persists.
Our goal was to review our experience with continent
urinary diversion in our patients with inoperable
vesicovaginal fistula (VVF).
Methods The database of patients who underwent urinary diversion
at ECWA Evangel VVF Centre in Jos, Nigeria, between
1996 and 2012, was reviewed. Complications and surgical
outcomes were noted. The earlier patients (1996–2002)
and the later patients (2003–2012) were compared.
Results Urinary diversions were performed on 118 patients.
Compared with the earlier patients, the later patients
more often underwent modified Mainz II diversions,
had similar complication rates, but had better outcomes.
The use of ureteric catheters intraoperatively and
the performance of modified Mainz II pouch were associated
with a better outcome. Overall perioperative mortality
was 2.5 %.
Conclusions Urinary diversion is feasible in a low-resource
setting. Use of modified Mainz II pouch diversion and intraoperative
ureteric catheters were associated with a better outcome.
Urinary diversion should be undertaken only after the
careful counseling of each patient, and by an experienced
surgeon.
