Epidemiological, anatomoclinical, and therapeutic profile of obstetric fistula in the Democratic Republic of the Congo: About 1267 patients

Author:

Paluku Justin Lussy12ORCID,Sikakulya Franck Katembo34ORCID,Furaha Cathy Mufungizi12,Kamabu Eugénie Mukekulu5,Aksanti Barthelemy Kasi2,Tsongo Zacharie Kibendelwa6,Wembonyama Stanis Okitotsho7,Mpoy Charles Wembonyama8,Juakali Jeannot Sihalikyolo9

Affiliation:

1. Department of Obstetrics and Gynecology, Faculty of Medicine University of Goma Goma Democratic Republic of the Congo

2. Department of Obstetrics and Gynecology HEAL Africa Hospital Goma Democratic Republic of the Congo

3. Department of Surgery, Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Ishaka‐Bushenyi Uganda

4. Department of Surgery, Faculty of Medicine Université Catholique du Graben Butembo Democratic Republic of the Congo

5. Department of Internal Medicine HEAL Africa Hospital Goma Democratic Republic of the Congo

6. Department of Internal Medicine, Faculty of Medicine University of Kisangani Kisangani Democratic Republic of the Congo

7. Departments of Pediatrics and Public Health, Faculty of Medicine University of Lubumbashi Lubumbashi Democratic Republic of the Congo

8. Department of Obstetrics and Gynecology, Faculty of Medicine University of Lubumbashi Lubumbashi Democratic Republic of the Congo

9. Department of Obstetrics and Gynecology, Faculty of Medicine University of Kisangani Kisangani Democratic Republic of the Congo

Abstract

AbstractObjectiveOur aim is to describe the epidemiological, anatomoclinical and therapeutic profile of obstetric fistula (OF) in the Democratic Republic of the Congo (DRC).MethodologyThis was a descriptive retrospective study that collected 1416 obstetric fistulas in 1267 patients in seven provinces of the DRC, treated between January 2017 and December 2022. The variables studied were epidemiological, anatomoclinical and therapeutic.ResultsThe mean age of patients at the time of surgical repair was 33.2 years (range: 15 and 77 years) and 32.8% of patients were aged between 20 and 29 years. The mean age of the fistula at repair was 10 years (range: 3.5 months and 56 years). At the time of fistula, 61.7% of patients had delivered vaginally and 28.7% by caesarean section and 8.2% of patients had a haemostasis hysterectomy. Labour lasted at least 3 days in 47.3% of these patients for the fistula birth. Deliveries took place either at home (27.4%) or in a health facility (72.6%); 83.6% of newborns resulting from these births had died. Taken as a whole, urogenital fistulas are more common than genito‐digestive fistulas. Urethro‐vaginal (26.2%) and vesico‐uterine (24.7%) anatomoclinical entities were predominant among urogenital fistulas. A total of 1416 fistulas were surgically repaired in 1267 patients. These repairs were successful for 1226 (86.6%) fistulas. The main surgical route used was transvaginal (68.8%).ConclusionIn the DRC, obstetric fistula is common in young adult women. It often results from vaginal delivery, after prolonged labour. Fistula births often result in the death of newborns. Uro‐genital obstetric fistulas are the most frequent with predominance of urethro‐vaginal and vesico‐uterine anatomoclinical entities. Fistulas remain untreated for a long time. Mostly done transvaginally, surgical repair gives a good result.

Publisher

Wiley

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