Cases of fistula on the rise, doctors concerned

Kathmandu, May 28

Gynaecologists have expressed their concern about the increasing number of surgical fistula cases in the country.

As per a data provided by Kathmandu Model Hospital, reconstructive surgeries were performed on 40 women who suffered from surgical fistula in the last three years.

“The problem is increasing mainly because there are more patients undergoing caesarean section procedure during which women are at high risk of being injured in the urethra and urinary bladder,” informed Dr Aruna Karki, head of the Department of Gynaecology and obstetrics as well as a fistula surgeon at Kathmandu Model Hospital.

The number of women suffering from obstetric fistula is also on the rise, according Dr Karki.

According to a 2011 UNFPA report, an estimated 200 to 400 women in the country suffer from obstetric fistula every year.

“An obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labour, leaving a woman incontinent of urine or faeces or both,” said Dr Karki.

Women who develop obstetric fistula end up giving birth to a stillborn baby. Women suffer from urinary incontinence or faecal incontinence if they suffer from fistula.

“It is necessary to go for caesarean section  if a woman can’t give birth to a baby within eight hours of labour pain,” added Dr Karki.

According to hospital data, 80 new patients of fistula visit the hospital yearly. “There are many women who don’t have access to hospitals in the country. There aren’t many hospitals in the country that provide treatment for fistula. Thus, many cases of fistula go unnoticed,” added the doctor.

One of the causes for obstetric fistula in women is early marriage. “The pelvis isn’t properly developed. This is why the tissues get damaged during delivery. And, if a woman suffers from fistula, surgery is a must for delivery. “Malnutrition too is a major cause for fistula in women and girls,” said the doctor.

Because of lack of awareness and fear of social stigma, many women do not want to talk about their health problems due to which many women in the country are compelled to live with diseases for years.

If left untreated, obstetric fistula causes chronic incontinence and can lead to frequent infections and renal diseases. Obstetric fistula can be prevented and in most cases treated. Reconstructive surgery with a trained, expert fistula surgeon can cure the injury.