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Urinary diversion for patients with inoperable obstetric vesicovaginal fistula: the Jos, Nigeria experience

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Abstract

Introduction

Repair of obstetric urinary fistula may result in successful fistula closure, but often incontinence persists. Our goal was to review our experience with continent urinary diversion in our patients with inoperable vesicovaginal fistula (VVF).

Methods

The database of patients who underwent urinary diversion at ECWA Evangel VVF Centre in Jos, Nigeria, between 1996 and 2012, was reviewed. Complications and surgical outcomes were noted. The earlier patients (1996–2002) and the later patients (2003–2012) were compared.

Results

Urinary diversions were performed on 118 patients. Compared with the earlier patients, the later patients more often underwent modified Mainz II diversions, had similar complication rates, but had better outcomes. The use of ureteric catheters intraoperatively and the performance of modified Mainz II pouch were associated with a better outcome. Overall perioperative mortality was 2.5 %.

Conclusions

Urinary diversion is feasible in a low-resource setting. Use of modified Mainz II pouch diversion and intraoperative ureteric catheters were associated with a better outcome. Urinary diversion should be undertaken only after the careful counseling of each patient, and by an experienced surgeon.

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Authors and Affiliations

  1. ECWA Evangel VVF Centre (now Bingham University Teaching Hospital), Jos, Nigeria

    Carolyn V. Kirschner, Sunday J. Lengmang, George A. A. Chima, Jonathan A. Karshima & Steven Arrowsmith

  2. North Shore University Health System, 2650 Ridge Avenue, Walgreen Building Suite 1507, Evanston, IL, 60201, USA

    Carolyn V. Kirschner & Ying Zhou

  3. Fistula Foundation, San Jose, CA, USA

    Sunday J. Lengmang & Steven Arrowsmith

  4. Jos University Teaching Hospital, Jos, Nigeria

    Jonathan A. Karshima

Authors
  1. Carolyn V. Kirschner
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  2. Sunday J. Lengmang
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  3. Ying Zhou
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  4. George A. A. Chima
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  5. Jonathan A. Karshima
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  6. Steven Arrowsmith
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Corresponding author

Correspondence to Carolyn V. Kirschner.

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Kirschner, C.V., Lengmang, S.J., Zhou, Y. et al. Urinary diversion for patients with inoperable obstetric vesicovaginal fistula: the Jos, Nigeria experience. Int Urogynecol J 27, 865–870 (2016). https://doi.org/10.1007/s00192-015-2871-x

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  • DOI: https://doi.org/10.1007/s00192-015-2871-x

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