Current Management of Obstetric Fistula: Implication for the Low Resource Areas
Aniefiok Jackson Umoiyoho and Wilson Emurobohwo Ugege
Affiliation: Department of Obstetrics and Gynaecology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.
Keywords: Current trends, laparoscopic surgery, maternal morbidity, obstetric fistula.
Obstetric fistula is a form of maternal morbidity which may occur in any woman of reproductive age who
suffers from prolonged obstructed labor or traumatic attempt at vaginal delivery. The medical and social consequences of
obstetric fistula can be life-shattering for women, their children and families.
The principles of obstetric fistula repair have changed very little over the years, though a number of them are often
modified by the cost, efficacy of treatment modality, and skill of the surgeon.
Advances in other areas of surgery such as laparoscopic surgery have led to more precise identification of fistulous
urogenital tracts and improved precision of tissue plane dissection and repair.
Robotic surgery was a significant improvement in laparoscopy. It reduces operating fatigue and eliminates unpredictable
movements and tremors common with human hands during laparoscopy.
The introduction and wide spread use of surgical glue will ultimately reduce the need for interpositional tissue flaps.
However, unavailability of resources to deploy these current trends in the management of obstetric fistula in resource poor
setting may limit the use of these modalities in such areas where most of the cases occur.
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