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|Title: ||The Epidemiology of Genitourinary Fistulae in Kumasi, Ghana, 1977-1992|
|Authors: ||Danso, K. A.|
Martey, J. O.
Wall, L. L.
Elkins, T. E.
|Keywords: ||Obstetric fistula|
|Issue Date: ||26-Sep-2011|
|Abstract: ||The aim of the study was to determine the
clinical epidemiology of genitourinary fistulae as seen at
Komfo Anokye Teaching Hospital in Kumasi, Ghana.
A retrospective study was carried out from the hospital
records and operative reports of all patients with
genitourinary fistulae seen at Komfo Anokye Teaching
Hospital between January 1977 and December 1992.
Patient age, parity, type of fistula and cause of fistula
were, abstracted from the medical records. There were
164 cases of genitourinary fistula managed during the
study period. There were 150 fistulae due to obstetric
causes (91.5%), the vast majority of which were due to
prolonged obstructed labor (121 cases, 73.8% of all
ifstulae), with a minority related to complications of
lower-segment cesarean section (14 cases, 8.5% of all
ifstulae). In 5 cases (3.1%) patients developed a recto-
vaginal fistula owing to perineal tears and prolonged
obstructed labor. During this time period there were
157 449 deliveries, giving an obstetric fistula rate of 1
ifstula per 1000 deliveries. Obstetric fistulae were most
common at the extremes of reproductive age and parity.
Fourteen additional fistulae (8.5% of all cases) were due
to gynecologic causes, most commonly from surgical
injury occurring at the time of abdominal hysterectomy
for leiomyomata uteri (12 cases, 7.3% of all fistulae). It
was concluded that in Kumasi, Ghana, obstetric trauma
from prolonged obstructed labor is the most common
cause of genitourinary fistula formation. Such fistulae
occur in older multiparous women as well in young
primigravidae. Obstructed labour can, and does, occur
in women who have previously undergone uneventful
vaginal delivery. Birth attendants should be aware of that fact. Prompt referral for obstetric intervention should be made in obstructed labor, irrespective of the age and parity of the patient.|
|Description: ||This published article by K. A. Danso...[et.al]|
|Appears in Collections:||College of Health Sciences|
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