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The immediate surgical management of fresh obstetric fistulas with catheter and/or early closure
Author(s) -
Waaldijk K.
Publication year - 1994
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/0020-7292(94)90759-5
Subject(s) - medicine , fistula , surgery , catheter , closure (psychology) , conservative management , economics , market economy
OBJECTIVES: To determine prospectively if the immediate surgical management of obstetric fistulas within the first 3 months by catheter and/or early closure is effective. METHODS: During a 10‐month period (August 1992 through May 1993), a total of 170 patients with an obstetric fistula of less than 3 months' duration were treated. A catheter was inserted if the fistula was necrotic, and as soon as the fistula edge was clean an early closure was performed unless the fistula had healed already. RESULTS: The fistula was closed in 156 (91.8%) of the 170 consecutive patients: with continence in 146 (93.6%), minimal/mild incontinence in 7 (4.5%) and severe incontinence in 3 (1.9%) of the closed fistulas. In 14 patients (8.2%) the fistula was not closed at first intention; however, 12 were closed at the second attempt. CONCLUSION: The immediate surgical management proved highly effective in terms of closure and continence.