Postpartum Vesicovaginal Fistulas: Risk Factors, Prevention and Treatment Strategies
DOI:
https://doi.org/10.70749/ijbr.v3i2.630Keywords:
Postpartum, Vesicovaginal Fistula, Risk Factors, Prevention, Surgical Treatment, Psychosocial Impact, Antenatal Care, Obstructed LaborAbstract
Background: Postpartum vesicovaginal fistulas (VVFs) are a significant complication of childbirth, particularly in low-resource settings, leading to long-term physical and psychosocial challenges for affected women. Objective: This study aims to identify the key risk factors, assess the effectiveness of prevention strategies, and evaluate surgical treatment outcomes for postpartum VVFs. Methods: This retrospective cohort study was conducted at Avicenna Hospital, Lahore, July to December 2024. A total of 123 women diagnosed with postpartum VVFs were included in the study. Data were collected through retrospective chart reviews and structured patient interviews. Key variables extracted from medical records included demographic information such as age, education level, and socioeconomic status. Results: The majority of the participants (72%) were multiparous, and 56% of cases were associated with obstructed labor. Women with inadequate antenatal care (28%) and those attended by non-skilled birth attendants (14%) had a significantly higher risk of developing VVFs. Surgical repair was successful in 85% of cases, with vaginal repair achieving an 80% success rate. Post-surgical complications, such as infections and urinary retention, were minimal, affecting 8% and 4% of the cases, respectively. A notable psychosocial impact was observed, with 65% of women reporting emotional distress and 59% experiencing social isolation due to the condition. Conclusions: Postpartum VVFs are strongly associated with obstructed labor, prolonged delivery, and inadequate antenatal care. Early intervention and skilled birth attendance are crucial for preventing VVFs.
Downloads
References
Shrestha, D. B., Budhathoki, P., Karki, P., Jha, P., Mainali, G., Dangal, G., Baral, G., Shrestha, M., & Gyawali, P. (2022). Vesico-vaginal fistula in females in 2010–2020: A systemic review and meta-analysis. Reproductive Sciences, 29(12), 3346-3364. https://doi.org/10.1007/s43032-021-00832-8
Wall, L. L. (2006). Obstetric vesicovaginal fistula as an international public-health problem. The Lancet, 368(9542), 1201-1209. https://doi.org/10.1016/s0140-6736(06)69476-2
Rogers, R. G., & Jeppson, P. C. (2016). Current diagnosis and management of pelvic fistulae in women. Obstetrics & Gynecology, 128(3), 635-650. https://doi.org/10.1097/aog.0000000000001519
Sofoudis, C., Bitzi, G., & Salvanos, G. (2023). Vesicovaginal Fistulas (VVF): New Dilemmas and Prospectives Review of the Literature. J Obst Gynecol Surg, 4(1), 10-14. https://respubjournals.com/obstetrics-gynecological-surgery/pdf/Vesicovaginal-Fistulas-VVF-New-Dilemmas-and-Prospectives-Review-of-the-Literature.pdf
Rajaian, S., Pragatheeswarane, M., & Panda, A. (2019). Vesicovaginal fistula: Review and recent trends. Indian Journal of Urology, 35(4), 250. https://doi.org/10.4103/iju.iju_147_19
Ngoma, J. (2011). Prevention of Vesicovagina fistula: a literature review and experience from Zambia. https://www.theseus.fi/bitstream/handle/10024/26462/Josephine%20ngoma%20thesis.pdf?sequence=1
Hilton, P. (2006). Vesico-vaginal fistulas in developing countries. In Textbook of Perinatal Medicine (pp. 2196-2205). CRC Press.
Wall, L. L., Arrowsmith, S. D., Briggs, N. D., Browning, A., & Lassey, A. (2005). The obstetric Vesicovaginal fistula in the developing world. Obstetrical & Gynecological Survey, 60(Supplement 1), S3-S51. https://doi.org/10.1097/00006254-200507001-00002
Nambala, N., 2012. A study to determine women's intention to prevent Vesico-Vaginal Fistula recurrence in two repair centres in Zambia (Doctoral dissertation).
Bonavina, G., Busnelli, A., Acerboni, S., Martini, A., Candiani, M., & Bulfoni, A. (2023). Surgical repair of post‐cesarean vesicouterine fistula: A systematic review and a plea for prevention. International Journal of Gynecology & Obstetrics, 165(3), 894-915. https://doi.org/10.1002/ijgo.15256
Polan, M. L., Sleemi, A., Bedane, M. M., Lozo, S., & Morgan, M. A. (2015). Obstetric fistula. Disease Control Priorities, Third Edition (Volume 1): Essential Surgery, 95-108. https://doi.org/10.1596/978-1-4648-0346-8_ch6
Abdi, S. S. M. (2018). Factors contributing to obstetrical fistulas among mothers attending post natal clinic at Jinja Regional Referral Hospital. https://ir.kiu.ac.ug/handle/20.500.12306/4273
Bulndi, L. B., Ireson, D., Adama, E., & Bayes, S. (2022). Sub-saharan African women’s views and experiences of risk factors for obstetric fistula: A qualitative systematic review. BMC Pregnancy and Childbirth, 22(1). https://doi.org/10.1186/s12884-022-05013-2
Satora, M., Żak, K., Frankowska, K., Misiek, M., Tarkowski, R., & Bobiński, M. (2023). Perioperative factors affecting the healing of Rectovaginal fistula. Journal of Clinical Medicine, 12(19), 6421. https://doi.org/10.3390/jcm12196421
Mama, S. T., & Chandra Regmi, M. (2022). Pelvic floor disorders/Obstetric fistula. Obstetrics and Gynecology Clinics of North America, 49(4), 735-749. https://doi.org/10.1016/j.ogc.2022.08.001
Morhason-Bello, I. O., Kareem, Y. O., Abdus-Salam, R. A., Bello, O. O., Lawal, O. O., Akinlusi, F. M., Abegunde, L. O., & Ojengbede, O. (2020). Factors associated with the awareness of vaginal fistula among women of reproductive age: Findings from the 2018 Nigerian demographic health cross-sectional survey. BMJ Open, 10(11), e040078. https://doi.org/10.1136/bmjopen-2020-040078
Swain, D., Parida, S. P., Jena, S. K., Das, M., & Das, H. (2020). Prevalence and risk factors of obstetric fistula: Implementation of a need-based preventive action plan in a south-eastern rural community of India. BMC Women's Health, 20(1). https://doi.org/10.1186/s12905-020-00906-w
Pandit, H., Tajane, A., Wagholika, H., & Shaikh, A. (2024). Vesico vaginal fistula. Complex Total Laparoscopic Hysterectomy (TLH) with Newer Approaches in Bladder Dissection, 233-244. https://doi.org/10.1007/978-981-97-3226-5_23
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research

This work is licensed under a Creative Commons Attribution 4.0 International License.