Obstetric fistula

Obstetric fistula
Diagram of maternal and foetal sequelae of prolonged obstructed labour, increasing the risk of obstetric fistula.
Diagram of maternal and foetal sequelae of prolonged obstructed labour, highlighting areas that are at high risk of developing obstetric fistula(s).
SpecialtyUrology, gynecology
SymptomsIncontinence of urine or feces[1]
ComplicationsDepression, infertility, social isolation[1]
Usual onsetChildbirth[1]
Risk factorsObstructed labor, poor access to medical care, malnutrition, teenage pregnancy[1][2]
Diagnostic methodBased on symptoms, supported methylene blue[3]
PreventionAppropriate use of cesarean section[1]
TreatmentSurgery, urinary catheter, counseling[1][3]
Frequency2 million (developing world), rare (developed world)[1]

Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth.[1][2] This can be between the vagina and rectum, ureter, or bladder.[1][4] It can result in incontinence of urine or feces.[1] Complications may include depression, infertility, and social isolation.[1]

Risk factors include obstructed labor, poor access to medical care, malnutrition, and teenage pregnancy.[1][2] The underlying mechanism is poor blood flow to the affected area for a prolonged period of time.[1] Diagnosis is generally based on symptoms and may be supported by use of methylene blue.[3]

Obstetric fistulae are almost entirely preventable with appropriate use of cesarean section.[1] Treatment is typically by surgery.[1] If treated early, the use of a urinary catheter may help with healing.[3] Counseling may also be useful.[1] An estimated 2 million people in sub-Saharan Africa, Asia, the Arab region, and Latin America have the condition, with about 75,000 new cases developing a year.[1] It occurs very rarely in the developed world and is considered a disease of poverty.[5]

  1. ^ a b c d e f g h i j k l m n o p q "Obstetric fistula". UNFPA - United Nations Population Fund. 8 May 2017. Retrieved 12 December 2017.
  2. ^ a b c "10 facts on obstetric fistula". WHO. May 2014. Retrieved 12 December 2017.
  3. ^ a b c d Creanga AA, Genadry RR (November 2007). "Obstetric fistulas: a clinical review". International Journal of Gynaecology and Obstetrics. 99 (Suppl 1): S40-6. doi:10.1016/j.ijgo.2007.06.021. PMID 17868675. S2CID 23859968.
  4. ^ Setchell ME, Hudson CN (2013). Shaw's Textbook of Operative Gynaecology - E-Book. Elsevier Health Sciences. p. 370. ISBN 978-8131234815.
  5. ^ Disch L, Hawkesworth M (2015). The Oxford Handbook of Feminist Theory. Oxford University Press. p. 821. ISBN 9780199328598.

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