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Catheter treatment as a low-cost power tool in 2.302 patients with a fresh obstetric urine fistula; a call for mass campaign
Kees WAALDIJK11National Obstetric Fistula Center, Babbar Ruga, Nigeria
To show the impact of early indwelling bladder catheterization with high oral fluid intake as an important tool in the immediate management of the obstetric urine fistula. A total of 2.302 patients with an obstetric urine fistula of less than 3-month duration had an indwelling bladder inserted for 4 weeks together with high oral fluid intake upon arrival in the referral center. Several relevant patient and fistula date were given. Out of the total of 2.302 patients the result was healing of the fistula in 1.398 or 61% by this immediate management. The patents not healed by catheter were operated the day after catheter removal. Final overall healing by catheter and/or early closure was achieved in 2.212 patients or 96% with total incontinence in 24 or 1% and milder incontinence but social continence in 20 or 1%. A failure was noted in 23 patients or 1% including mortality in 6 or 0.3%. The outcome was unknown in 67 patients or 3% who did not report for follow-up after catheter insertion. The results were further analyzed as to duration of leaking, as to fistula size, as to Kees classification and as to fistulas related to cesarean section. The early indwelling bladder catheterization with high oral fluid intake as part of the immediate management is highly effective in the treatment of the obstetric urine fistula. If this management could be implemented in any patient with an obstetric urine fistula it would drastically reduce the caseload of patients in the world waiting for an operation, especially since a catheter can be inserted in any setting by a nurse, a midwife or a doctor under low cost.
Cite This Article
WAALDIJK K. Catheter treatment as a low-cost power tool in 2.302 patients with a fresh obstetric urine fistula; a call for mass campaign. 2024; 43(1): 40-47
Corresponding Author: WAALDIJK K.
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