Women's Health and Education Center (WHEC)

Obstetrical Fistulae

Editor's Note

To understand the cause of fistulae one must understand wound healing because it is a defect or vulnerability in this process that results in fistula development. Between the first and third weeks healing is most vulnerable to hypoxia, ischemia, malnutrition, radiation, and chemotherapy, so this is the time when most fistulae are clinically seen. The vast majority of vesico-vaginal fistulae and recto-vaginal fistulae that occurs in developing countries is caused by obstetric trauma and obstructed labor. Childbearing at a young age may occur before full growth and development of the pelvis. Absent or untrained birth attendants, reduced pelvic dimensions, malnutrition, and introital stenosis secondary to tribal circumcision all contribute to obstructed labor. It is estimated about 1 million women suffer from this devastating situation. In modern obstetrics, most of these conditions do not exist.

The social consequences of ostracism take an enormous toll on affected women; divorce is common, and depression and suicide may follow. Many women are unaware that the condition is treatable, and are prevented from learning about appropriate care by severe social isolation as a result of their incontinence. Few area hospitals in developing countries have the staff, equipment, or expertise to manage the overwhelming problem. Poverty, long distances, and long waiting lists deter women from traveling to major centers.

We hope our forums are helpful in suggesting solution to this devastating situation.

Women's Health and Education Center (WHEC)

Women's Health & Education Center
Dedicated to Women's and Children's Well-being and Health Care Worldwide