ABSTRACT
To find out the factors involved in fistula formation causing increased prevalence of fistula despite improved health facilities. This descriptive study was carried out in the Department of Obstetrics and Gynaecology, Nishtar Hospital, Multan from January 2006 to December 2007. A total of 66 patients were included in the study. Out of 20068 admitted patients 66 were found to be having fistula with frequency of 0.32%. Genito-urinary fistula were amongst 58 of 66 patients [80.3%] and recto-vaginal fistula in rest of 13 patients [19.7%]; frequency being 0.26% and 0.06% respectively. latrogenic causes were accountable for 47 fistula patients [71.2%] and obstructed labour was culprit for 19 of 66 patients [28.8%]. So, surgical trauma came out to be the major reason for fistula formation. Mean age was 34 years and mean parity 4. fistula size was 0.5-4 cm, while success rate for repair was 90.9% [6 failed out of 66]. In our study surgical trauma, responsible for major bulk of fistula patients, proved to be the main culprit for increasing prevalence of fistula in Multan