TY - JOUR
T1 - Characteristics of Genitourinary Fistula in Kigali, Rwanda; 5-Year Trends
AU - Richter, Lee A.
AU - Lee, Harry
AU - Nishimwe, Arlene
AU - Niteka, Lysa C.
AU - Kielb, Stephanie J.
N1 - Funding Information:
Financial Disclosure: The authors declare that they have no relevant financial interests.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/4
Y1 - 2021/4
N2 - OBJECTIVE: To assess the characteristics of women presenting with genitourinary fistula over a 5-year period in Kigali, Rwanda. Genitourinary (GU) fistula is a devastating condition that can result from difficult vaginal deliveries or as a surgical complication. Rwanda has seen notable increases in cesarean section rates as a result of a successful universal health care system. It is unclear how the increase in cesarean section rates may influence the types of fistula diagnosed. MATERIALS AND METHODS: A cross-sectional study was conducted of women presenting for evaluation to the International Organization for Women and Development in Kigali, Rwanda, between February 1, 2013 and October 31, 2017. Data were collected from medical records, including demographics, surgical history, physical exam findings, and surgical intervention. RESULTS: Two thousand ninety-one women presented for evaluation during the study period, of these 630 (30%) were diagnosed with GU fistula. Of the fistula diagnosed, 392 (62%) were vesicovaginal fistula, 185 (29%) were vesicouterine or vesicocervical, and 56 (9%) were ureterovaginal fistula. The percent of GU fistula that involved the ureter, uterus, and/or cervix significantly increased over the time period: 29.6% in 2013, 34.6% in 2014; 43.0% in 2015, 42.9% in 2016, and 45.3% in 2017. CONCLUSION: There was a significant increase in the proportion of vesicouterine, vesicocervical, and ureterovaginal fistula presenting in Rwanda over the 5-year period, with the majority occurring after cesarean section.
AB - OBJECTIVE: To assess the characteristics of women presenting with genitourinary fistula over a 5-year period in Kigali, Rwanda. Genitourinary (GU) fistula is a devastating condition that can result from difficult vaginal deliveries or as a surgical complication. Rwanda has seen notable increases in cesarean section rates as a result of a successful universal health care system. It is unclear how the increase in cesarean section rates may influence the types of fistula diagnosed. MATERIALS AND METHODS: A cross-sectional study was conducted of women presenting for evaluation to the International Organization for Women and Development in Kigali, Rwanda, between February 1, 2013 and October 31, 2017. Data were collected from medical records, including demographics, surgical history, physical exam findings, and surgical intervention. RESULTS: Two thousand ninety-one women presented for evaluation during the study period, of these 630 (30%) were diagnosed with GU fistula. Of the fistula diagnosed, 392 (62%) were vesicovaginal fistula, 185 (29%) were vesicouterine or vesicocervical, and 56 (9%) were ureterovaginal fistula. The percent of GU fistula that involved the ureter, uterus, and/or cervix significantly increased over the time period: 29.6% in 2013, 34.6% in 2014; 43.0% in 2015, 42.9% in 2016, and 45.3% in 2017. CONCLUSION: There was a significant increase in the proportion of vesicouterine, vesicocervical, and ureterovaginal fistula presenting in Rwanda over the 5-year period, with the majority occurring after cesarean section.
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U2 - 10.1016/j.urology.2020.05.077
DO - 10.1016/j.urology.2020.05.077
M3 - Article
C2 - 32590083
AN - SCOPUS:85087945574
SN - 0090-4295
VL - 150
SP - 165
EP - 169
JO - Urology
JF - Urology
ER -
