Genito-urinary fistula patients at Bugando Medical Centre.

BACKGROUND Information was collected on 1500 obstetric fistula patients attending Bugando Medical Centre (BMC) in Mwanza, Tanzania. OBJECTIVES To identify high risk populations of fistula patients treated from 1998-2006. DESIGN A prospective description study of 1294 patients treated for urine and faecal incontinence at BMC. SETTING Obstetrics and Gynaecological ward at Bugando Medical Centre. INTERVENTIONS A total of 1294 patients underwent surgical treatment of incontinence. MAIN OUTCOME MEASURES Of the 1294 surgical repairs, 84% of the patients were cured, 12% had stress incontinence and 4% failed. CONCLUSIONS The study shows that low education and poverty were the key factors in the development of fistula. Most obstetric fistulae can be cured, particularly during the first attempt by those properly trained in the skills. Prevention of genital fistula requires raising the education and social status of women including poverty reduction strategies, improving the quality of antenatal care. Increased access to Caesarean section is also needed for prevention of genitourinary fistulas.