142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Insight from 5,000 Female Genital Fistula Follow-up Encounters in Jos, Nigeria

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 8:54 AM - 9:06 AM

Sunday Lengmang, MD, MPH , Evangel Vesico-Vaginal Fistula Center, Bingham University Teaching Hospital, Jos Nigeria, Jos, Nigeria
Hannah Degge, MPH , Bingham University Teaching Hospital, Jos, Nigeria
Lohna Lengmang, Bsc Sociology , Reproductive Trauma Eradication Centre, Jos Nigeria, Jos, Nigeria
Comfort Olorunsaiye, MPH, Doctoral student , College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC

The study sought to identify when and why women who had surgery for genital fistula attend follow-up.



Obstetric fistula, an international public health problem affects two million women from sub-saharan Africa and South Asia. Although it is the worst maternal mobidity known to man, little is known about follow-up experiece of women following surgical repair. This study sought to gain insight into their post-operative experience.



The study is a descriptive analysis of 5,000 consecutive follow-up encounters of women treated from genital fistula from January 2000 to December 2013. The data was captured and cleaned from a database in Microsoft Access; exported to SPSS version 17 for descriptive analysis; and charts were generated using Microsoft Excel.



Within 12 months of discharge after surgery, 80.8% of follow-up attendees presented regardless the surgical outcome.  53.7% of the women attended follow-up routinely, having attained continence with no further complaint; 34.1% attended follow-up because of persistent incontinence; while 12.2% had other clinical complaints. At 7 to 12 months follow-up, 91% of attendees desiring to have sex achieved penetrative vaginal sex freely. 1.6% of attendees desiring to have sex could not achieve adequate penetrative vaginal sex.



  1. Fistula centers should plan to follow-up their patients within the first year of repair regardless of surgical outcome.
  2. Fistula centers should proactively look for and plan to resolve issues related to persistent fistula, other complaints and capacity for penetrative vaginal intercourse.
  3. Further research should explore pregnancy and its outcome among women following successful treatment.

Learning Areas:

Clinical medicine applied in public health

Learning Objectives:
List reasons why women treated for genital fistula attend for follow up Analyze the sexual experiences of women who desired penetrative vaginal intercourse after surgical treatment for genital fistula.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I hold an MBBS certificate from the University of Jos, a Fellowship of the West African College of Physicians in Family Medicine, an MPH certificate from the University of Leeds, UK. I have been Project Director at Evangel Vesico-Vaginal Fistula center of Bingham University Teaching Hospital Jos, Nigeria and a practicing Fistula surgeon for ten years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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