ABSTRACT
Vesico-vaginal Fistula [VVF] is defined as an abnormal communicating tract extending between the bladder [vesico-] and the vagina resulting in continuous involuntary discharge of urine into the vaginal vault. Vesico-vaginal fistula is still a persisting scourge in the developing countries, including Sudan in which 5000 new cases of obstetric fistula were estimated to occur every year. The objectives of this work were to study the contributing factors of vesico-vaginal fistula in Sudanese patients. The design was descriptive, cross-sectional, community-based study. A total of 2 patients with vesicovaginal fistula presented to the Fistula Centre in Khartoum Teaching Hospital from July to August 2008 were investigated using an administrated, semi-structured questionnaire. The study revealed that 44.2% of patients were 18-24 years old 58.8% were teenagers when married [<18 yrs old]. While 7% of the patients were illiterates, 62.8% were married to illiterate husbands. [80.8%] were poor, [40.4%] were from western regions of Sudan. The study showed that labor was responsible for 90.4% of VVF of whom 59.6% were primiparous, 42.6% delivered at home. It was found that 40.4% of the total deliveries were by forceps as long as 27.7% were emergency caesarian sections. [53.2%] of the deliveries were attended by traditional birth attendants and 55.3% of cases stayed in labor for more than 24 hours, as long as 53.2% were not in regular antenatal care. The vesico-vaginal fistula in Sudan resulted mainly from obstructed labor. The victim was mostly a young woman, a primigravida, who was poor, illiterate, not on regular antenatal care and being in labor more than 24 hours. Most deliveries were carried at home, attended by Traditional Birth Attendants in most cases. The deliveries were mostly assisted by forceps, or conducted as emergency caesarian sections. To prevent VVF, the study suggested raising awareness of women at bearing age; improve transportation, besides inclusion of the issue in the curricula of schools and universities