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Rising trends in iatrogenic urogenital fistula: A new challenge
Journal – International Journal of Gynecology & Obstetrics
Publication date – Jan – 2020
Authors – Nasira Tasnim , Kauser Bangash, Oreekha Amin, Sobia Luqman , Hadia Hina
Keywords – Iatrogenic fistula; Obstetric fistula; Pakistan; Trends.
Open access – Yes
Speciality – Obstetrics and Gynaecology
World region South-eastern Asia
Language – English
Submitted to the One Surgery Index on May 12, 2020 at 5:23 am
Objective: To analyze trends in iatrogenic urogenital fistula among patients admitted for fistula repair at the Pakistan Institute of Medical Sciences, Islamabad.
Methods: In this longitudinal study, all patients who presented for fistula repair between 2006 and 2018 were included in the study. Patient data were collected on age, parity, and type and etiology of fistula, which was classified as ischemic or iatrogenic.
Results: Of 634 fistula patients, 371 (58.5%) had iatrogenic fistula, while 263 (41.5%) patients developed ischemic fistula due to obstructed labor. Mean age of patients was 31.6 years. Yearly trends showed an increase in iatrogenic fistula from 43.2% in 2006-2008 to 71.4% in 2017-2018. The major etiological contributor to iatrogenic fistula was hysterectomy (52.5%), followed by cesarean hysterectomy (26.4%), and cesarean delivery (19.9%).
Conclusion: A rising trend in iatrogenic fistula was observed. This emphasizes the need for optimization of surgical approaches and surgical skills. Moreover, gynecologic surgeries should be restricted to authorized gynecologic surgeons.
OSI Number – 20358
PMID – 31943186