Definition
An obstetric fistula is an abnormal opening between the vagina and the bladder/ureter or rectum of a woman that results in constant leakage of urine and/or faeces through the vagina. Women and girls with obstetric fistula are constantly soiled and wet, and they smell. According to World Health Organisation, obstetric fistula is the single most devastating consequence of obstructed/difficult labour to a mother in Sub-Saharan Africa.
Causes
- During obstructed labour, the bladder, vagina and rectum are compressed between the baby’s head and the pelvis. Prolonged pressure cuts off blood supply to the compressed tissue causing tissue death, sloughing and eventual “hole” between the bladder and vagina (Vesico-vaginal Fistula or VVF) or vagina and rectum (RVF) or both.
- Accidental surgical injuries especially Caesarean section/hysterectomy.
- Gynaecological cancers especially cancer of the cervix and its radiotherapy.
- Sexual abuse and rape.
- Complications of unsafe abortions
Complications/ Consequences
- Recurring infections.
- Infertility
- Painful sex.
- Paralysis of the muscles in their lower legs.
- Many are often abandoned by their husbands, families and communities and end up living in abject poverty.
- Affected young girls or women tend to live with their fear and stigmatization in silence and isolation, unknown to the health-care system.
By Dr. Nsenga Joseph
