Abstract:
Urinary incontinence resulting from genital fistulae has been on the increase for over
a decade now due to increased fistula care and treatment awareness and
improvement in access to care and treatment coupled with community awareness
program in which care and treatment intervention are now made possible close to
where the sufferers of fistulae live. A study carried out in our facility in 2007 showed
an annual fistulae case of about 300, while we currently diagnose between 400 and
500 cases annually. Besides vesicovaginal fistula (VVF) which is the commonest
female genital fistula, ureterovaginal fistula (UVF) appears to also be on the increase.
We therefore carried out a review of the diagnosis and surgical outcomes of ureteric
fistulae in order to ascertain the proportion of the female genital fistulae that are
UVF in order to proffer possible preventive measures. We also determined the
surgical success rates of ureteric fistulae cases repaired at Bingham University
Teaching Hospital. This retrospective study was conducted between January; 2017
and December; 2022. We reviewed the medical records looking at the final diagnosis
of all fistulae cases diagnosed over the period, diagnostic methods and causes of
ureteric fistulae, including their follow up data for six months post-surgery. All the
data extracted from the patients’ medical record were analyzed using IBM SPSS
version 26.Over the period of review, 2445 fistulae cases were diagnosed out of which
103 were ureteric fistulae/uretero-vaginal fistula (UVF) giving us a prevalence of
4.2%. The leading aetiological factors were caesarean delivery 74(71.8% of 103),
Myomectomy 13 (12.6% of 103) and congenital 9 (8.7% of 103). The surgical success
rate was 98.1% both at 3 and 6 months post-surgical repair. From the study,
Caesarean delivery is a common procedure in obstetric and delivery practice after
vaginal delivery and was responsible for 71.8% of 103 UVF found in our study.
Ureterovaginal fistulae have become a worrisome cause of urinary incontinence and
the left ureter affected more than the right ureter. The high success rate of 98.1% of
103 cases and less morbidity recorded is a reflection of surgical competency and
efficiency of the Fistulae care and treatment team at the centre.
