Predictors of late presentation for obstetric fistula repair in Abakaliki, South-East Nigeria.

Late presentation is a challenge to reducing the backlog of obstetric fistulas. We aimed to identify characteristics of women presenting late for repair in order to improve patient recruitment. It was a cross-sectional comparative study. Data was collected from the women and the hospital notes using proforma and analysed using SPSS. Associations between categorical variables were determined using Chi-square. Predictors of late presentation were determined using logistic regression. A P-value of <0.05 was statistically significant. The mean time of presentation was 42.3 months. Late presentation was significantly associated with age >35 years, parity < 3, not having a spouse, and trauma. On logistic regression, women aged 35 years and above were five times more likely to present late compared with younger ones (AOR= 5.192, 95%CI 1.839-14.660, P=0.002), while women with parity >3 were five times less likely to present late compared with those <3 (AOR= 0.208, 95%CI 0.073-0.587, P=0.003). In conclusion, most patients presented late. Although age, parity, having a spouse, and aetiology were associated with time of presentation, age >35 years and parity < 3 were the significant predictors of late presentation. Recruitment for early repair should be a priority area of the national policy for the elimination of obstetric fistula.

Enterocutaneous Fistula Coexisting with Enterovesical Fistula: A Rare Complication of Ovarian Cystectomy.

Enterocutaneous fistula is an abnormal communication between the intestine and the skin, while enterovesical fistula is an abnormal communication between the intestine and the bladder. Both are not usual complications of ovarian cystectomy. We present a patient with enterovesical fistula coexisting with enterocutaneous fistula following ovarian cystectomy. She is a 24- year-old lady with background immunosupression who presented to the National Obstetric Fistula Centre, Abakaliki South-East Nigeria with a history fecaluria, pneumaturia and passage of feculent fluid through the skin following ovarian cystectomy. Fistulogram was in keeping with rectovesical fistula. She was repaired in a single stage and made an uneventful recovery. Enterovesical fistula and enterocutaneus fistula are uncommon but possible complications of ovarian cystectomy.

Enterocutaneous fistula coexisting with enterovesical fistula: a rare complication of ovarian cystectomy

Enterocutaneous fistula is an abnormal communication between the intestine and the skin, while enterovesical fistula is an abnormal communication between the intestine and the bladder. Both are not usual complications of ovarian cystectomy. We present a patient with enterovesical fistula coexisting with enterocutaneous fistula following ovarian cystectomy. She is a 24-year-old lady with background immunosupression who presented to the National Obstetric Fistula Centre, Abakaliki South-East Nigeria with a history fecaluria, pneumaturia and passage of feculent fluid through the skin following ovarian cystectomy. Fistulogram was in keeping with rectovesical fistula. She was repaired in a single stage and made an uneventful recovery. Enterovesical fistula and enterocutaneus fistula are uncommon but possible complications of ovarian cystectomy

Bladder spasm following urogenital fistula repair.

OBJECTIVE: To examine the occurrence of bladder spasms following surgical repair of urogenital fistula. METHODS: The present retrospective study included data from patients who underwent surgical repair of urogenital fistula at the National Obstetric Fistula Centre, Abakaliki, Nigeria, between June 1, 2015, and May 31, 2016. Patients who underwent rectovaginal fistula repair and those who experienced persistent postoperative pain requiring high doses of analgesia were excluded. Bladder spasm was defined as the sudden onset of intermittent pain in the region of the bladder lasting for short periods of time in patients who were previously comfortable with routine postoperative analgesia. The incidence of bladder spasm was calculated and the presence of an association between repair outcome and bladder spasms was investigated. RESULTS: There were 133 patients included in the present study with a mean age of 36 ± 11 years. Bladder spasms were experienced by 60 (45.1%) patients during the study period; of these patients, failed fistula repair was recorded for 13 (22%). Good surgical outcome (closed fistula) was associated with not experiencing postsurgical bladder spasms (P=0.044). CONCLUSION: The incidence of bladder spasm following surgical repair of urogenital fistula appeared high. The occurrence of bladder spasms could influence repair outcomes.