Risk factors that predict failure after vaginal repair of obstetric vesicovaginal fistulae

Rahel Nardos, Andrew Browning, Chi Chiung Grace Chen

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Objective: To identify anatomic characteristics and method of bladder closure that predict failure after repair of obstetric vesicovaginal fistulae. Study Design: A retrospective analysis of 1045 patients that underwent vaginal repair of vesicovaginal fistulae from January 2006 to December 2007 at the Addis Ababa Hamlin Fistula Hospital. Results: The fistulae were midvaginal (26%), adjacent to ureteral orifice (22%), circumferential (6%), had urethral compromise (10%), or had a combination of different locations (17%). Most had fair or good residual bladder size (83%) and minimal or moderate vaginal scarring (85%). Closure was in 1 layer in 48% and 2 layers in 52% with 89% cure, 11% failure, and 17% urethral incontinence. Failures were significantly associated with complete or partial urethral destruction, severe vaginal scarring, small bladders, and circumferential involvement. The 1-layer fistula closure was associated with failure but not after excluding small bladders. Conclusion: Risk factors for failure include small bladder size, urethral destruction, circumferential involvement, and severe vaginal scarring.

Original languageEnglish (US)
Pages (from-to)578.e1-578.e4
JournalAmerican journal of obstetrics and gynecology
Issue number5
StatePublished - May 2009
Externally publishedYes

Bibliographical note

Copyright 2018 Elsevier B.V., All rights reserved.


  • obstetric fistula
  • surgical outcome
  • vesicovaginal fistula


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