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Women's Health and Education Center (WHEC)

Obstetrical Fistulae

List of Articles

  • Rectovaginal Fistula and Fecal Incontinence
    Childbirth is increasingly being recognized as commonly injuring the mother's anal sphincter complex. Fecal incontinence also appears to be associated with urinary incontinence and pelvic organ prolapse. Anal continence does not completely depend on intact sphincters; also important are intact neuromuscular function, including a functioning puborectalis muscle and pudendal nerve. This is supported by the fact that some women with sphincter lacerations remain continent. Anatomical knowledge of the anorectal canal is essential. Complications of anal sphincter laceration include anal incontinence, fecal urgency, perineal pain, and sexual dysfunction. Diagnostic studies, non-invasive therapies, and surgical management have all evolved in recent years. This has resulted in an improving outlook for women with this stigmatizing condition.

  • Surgical Management of Lower Urinary Tract Fistulas
    Obstructed labor remains the most important cause of vesicovaginal fistulas in developing countries. Absent or untrained birth attendants, reduced pelvic dimensions (caused by early childbearing, chronic disease, malnutrition, and rickets), uncorrected inefficient uterine action, malpresentation, hydrocephalus, and introital stenosis secondary to tribal circumcision all contribute to obstructed labor. The purpose of this document is to explore various surgical techniques for surgical repairs of lower urinary tract fistulas. Obstetric fistulas are characterized by considerable necrosis, sloughing, tissue loss, and cicatrisation. Vesicovaginal fistulas commonly occur in the setting of wide range of other immediate problems, such as stillbirth, ruptured uterus, third- or fourth-degree perineal lacerations with resultant rectovaginal fistulas and anal incontinence, and pelvic infection. In modern obstetrics, most of these conditions do not exist. Generalists should be trained to repair simple fistulas, with referral of complex cases to specialized fistula hospitals.

  • An Overview & Forums On Obstetrical Fistulae
    Obstetrical fistulae are the most devastating healthcare problem for women globally. In modern obstetrics its existence is negligible, yet each year over half a million women die of complications of pregnancy, childbirth or unsafe abortion. The vast majority of these deaths are in developing countries. For every woman who dies in childbirth, 30 to 50 women suffer injury, infection or disease. About 1 million women in the world suffer from obstetrical fistulae. Pregnancy related complications are among the leading causes of death and disability for women age 15-49 in developing countries. This is not a problem of developing countries only; it is about human beings in distress and pain. THE BEST TREATMENT & MANAGEMENT OF OBSTETRICAL FISTULAE IS PREVENTION.

  • Obstetrical Fistulae & Efforts Of The United Nations
    The United Nations is an organization of sovereign States and not a world government. It is an international organization comprising 192 Member States. As the "town hall of global affairs", its work affects our life every day. Clearly no single organization can solve crisis of maternal mortality and morbidity worldwide. Its causes are incredibly complex, and its solution requires more than good obstetrical care alone. The United Nations is irreplaceable as a forum for international dialogue. Global issues require global action and global initiatives involving both from industrialized and developing countries. Building strategic and coordinated responses to this tragedy is the way forward. The need to take a fresh look at development aid is vital. This manual is intended to be a practical guide to be read and used at many different levels by many different people, especially health-care professionals and planners, policy-makers and community leaders.

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