Authors: Mary Lake Polan, Mulu Muleta Bedane, Svjetlana Lozo, Mark A. Morgan, Ambereen Sleemi
Women who suffer obstetric fistulas, a serious and debilitating complication of childbirth affecting millions in the developing world, can undergo surgery to treat their incontinence and reduce their likelihood of renal failure, bladder damage, and gynecological and neurologic complications. The economic burden includes the patients’ loss of the ability to work and perhaps the loss of a society’s future workforce due to high rates of stillbirth and subsequent infertility while the cost of fistula surgery is estimated at US$1,000. Treatment involves patient selection and preoperative care, surgical repair, postoperative care and training, and reintegration into family and community life. At present no one model of treatment surpasses all others as superior, despite the work done at Addis Ababa Fistula Hospital and fistula camps managed by national and international teams. Training facilities should be developed to address the lack of trained medical personnel in surgery, and fistula care should be integrated into the services offices by local governmental institutions.