Online Program

Treatment preference of women with persistent obstetric fistula in Kano, Nigeria

Monday, November 2, 2015

Sunday Lengmang, MD, MPH, Evangel Vesico-Vaginal Fistula Center, Bingham University Teaching Hospital, Jos Nigeria, Jos, Nigeria
Amir Yola, MD, Laure VVF Centre, Laure VVF Centre, Kano, Nigeria
Hannah Degge, MPH, Faculty of Health and Social Care, University of Hull, Hull, United Kingdom
Comfort Olorunsaiye, MPH, College of Health and Human Services, UNC Charlotte, Charlotte, NC

The study sought to identify treatment preference of women with persistent obstetric fistula.


Obstetric fistula (OF) dehumanizes over two million poor women from sub-Saharan Africa and South Asia. Surgery is required for its prevention and treatment. Persistent OF survives repeated surgical interventions with dire consequences, but is credited with little if any scientific publication.


A mixed qualitative / quantitative study of women with persistent OF was carried out at Kano, Nigeria. Consenting women had quantitative and qualitative in-depth interview by a trained nurse. The qualitative data was analyzed with SPSS version 17; while charts were generated using Microsoft Excel. Thematic analysis was done for the qualitative data.


A typical woman with persistent OF was a childless divorcee who married at fifteen; endured urine incontinence for fourteen years from her first confinement which was preceded by two days labor with stillborn delivery and endured four failed surgical repairs. 85.7% declined diversion surgery as a solution for persistent OF. 38.1% of the women also had vaginal stenosis; 52.4% prefer treatment of vaginal stenosis rather than the fistula. None considered anal sex as alternative to vaginal sex.


Persistent obstetric fistula complicates adolescent deliveries, yet most victims decline diversion surgery. Vaginal stenosis often complicates persistent fistula and worsens misery, making it direr than the scourge of fistula, yet survivors decline anal sexual alternative.


  1. Obstetric fistula prevention should target young girls.
  2. Prevention and treatment of vaginal stenosis should be prioritized to forestall dire sexual and reproductive concerns.  

Learning Areas:

Clinical medicine applied in public health

Learning Objectives:
Identify treatment preference of women with persistent obstetric fistula.

Keyword(s): Adolescents, Labor

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, and 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 twelve 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.