What is Fistula?
VVF (Vesico Vaginal Fistula)
In Sierra Leone like in many other developing countries an unknown number of women suffer from one of the most severe of the pregnancy related complications – known as VVF – (vesico vaginal fistula).
VVF – is one of the worst morbidities that can ever occur to any woman on earth. It is a nightmare no woman can imagine.
VVF is a condition that can easily ruin a woman’s dreams and can transform even the most beautiful and admirable woman into a septic tank and an outcast. This three letter abbreviated word, the most common among obstetric fistulas, carries so much weight that it can hardly be compared.
Otherwise-medically known as vesico vaginal fistula, meaning an abnormal communication between the bladder and the vaginal wall, which is approximately 98% caused by obstructed labour.
An obstructed labour occurs when the baby’s head is unable to pass through the birth canal and is jammed in its maternal pelvis.
If this condition is not relieved on time by cesarean section, the anterior vaginal wall and the bladder become compressed between the fetal skull and maternal bony pelvis resulting in pressure necrosis.
This gives rise to a defect known as a fistula, through which there is a continuous leaking of urine that cannot be explained, stopped neither controlled by the woman affected.
RVF (Recto Vaginal Fistula)
Other obstetric fistulas include RVF (recto vaginal fistula), where a hole is between the vagina and rectum, vesico uterine fistula, and ureteric fistula among others. Due to the constant dribbling of urine down their legs, the wetting of their cloths and accompanying smell, most communities consider this woman an outcast.
Focusing simply on the hole between the bladder and the vagina ignores the multifaceted nature of the Injury that many of these patients sustained: to name a few:
- Urologic (complete urethral loss, renal failure etc.)
- Gynecologic (amenorrhea, cervical damage etc)
- Musculoskeletal-osteitis pubis
- Neurological (foot drop)
- Dermatological (chronic excoriations of the skin)
- Social Injury: (social isolation, divorce, worsening of poverty, malnutrition, suicide.
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