Obstetric fistula | |
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Diagram of maternal and foetal sequelae of prolonged obstructed labour, highlighting areas that are at high risk of developing obstetric fistula(s). | |
Specialty | Urology, gynecology |
Symptoms | Incontinence of urine or feces[1] |
Complications | Depression, infertility, social isolation[1] |
Usual onset | Childbirth[1] |
Risk factors | Obstructed labor, poor access to medical care, malnutrition, teenage pregnancy[1][2] |
Diagnostic method | Based on symptoms, supported methylene blue[3] |
Prevention | Appropriate use of cesarean section[1] |
Treatment | Surgery, urinary catheter, counseling[1][3] |
Frequency | 2 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]