Characterising women with obstetric fistula and urogenital tract injuries in Tanzania

Introduction and hypothesis: World Health Organisation (WHO) data suggest that more than two million women and girls live with fistula and that an additional 50-100,000 are newly affected each year. In Tanzania, it has been estimated that there are between 1,200 and 3,000 new cases of obstetric fistula annually. Methods: To characterize women undergoing surgery in 2011 for obstetric fistula repair at a disability hospital associated with Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), we identified routinely collected data and input into an Access database. Results: Women affected by obstetric fistulae in Tanzania are frequently young, poorly educated, primiparous, subsistence farmers or housewives and have experienced obstructed labour as a result of delays occurring at home and/or after reaching a health facility. The majority experienced stillbirth, particularly in cases of assisted or operative delivery. Success rates for fistula closure were high, at 91%, but residual incontinence on discharge from hospital was seen in 39%. Conclusions: Longer-term follow-up is required to determine rates of disabling residual incontinence and to examine demographics in greater depth, including variation between regions and in urban, periurban and rural settings in Tanzania. © The International Urogynecological Association 2013.