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vesico vagina fistula (VVF)

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Are you a  female circumcision victim? Or  know someone who is ? Or you are just here?.
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VVF is rumored to be caused by female circumcision but even at that ,let's read about it.

VESICO VAGINA FISTULA (VVF)
 
Meaning:
By definition, A Fistula is an abnormal connection between two epithelial surfaces and is lined by granulation tissues. vesico vagina fistula is an abnormal connection between the urinary bladder and vagina .
Causes includes:
1. Trauma to the anterior vagina wall
2. Obstetric problem such as in:
a . prolonged and obstructed labour.
b. destructive obstetrics operations.
c. Deep transverse arrest with subsequent forceps.
d. caesarean section
e. gishiri cut practiced in northern Nigeria
The obstetrics causes are common in short women with cephalo pelvic disproportion. Teenage mothers especially in nothern Nigeria are also implicated here.
3. Gynaecology problems such as :
a. hysterectomy
b. amputation of the cervix
4. infections
a. Lymphogranuloma venerum (LGV)
b. Schistosomiasis
The clinical features are as a
follows:
1. the woman leak and smell of urine
2. Excoriation around the inner aspect of the thigh.
3.The woman is socially stigmatized
4. she is usually infected by bacteria

TREATMENT:
If a woman has vvf due to obstetrics causes, the fistula is not repaired until after three months of delivery.
The management is conservative with ;
a. Broad spectrum antibiotics
b. Catheterise patients with forleys catheter for about two to three weeks. some fistula will heal and close on their own.
  The mainstay of management is surgery gir fistula that do not respond to conservative treatment.
Post operative management:
1. catheterise patients
2. analgesics
3. antibiotics
4. embark on bladder drill excersise after three weeks.
5. avoid intercourse for three months.
6. avoid pregnancy for one to one half years after surgery. 


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