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The relationship between female genital cutting and obstetric fistulae.

Abstract

OBJECTIVE
To evaluate any association between female genital cutting and vesicovaginal fistula formation during obstructed labor.
METHODS
A comparison was made between 255 fistula patients who had undergone type I or type II female genital cutting and 237 patients who had not undergone such cutting. Women were operated on at the Barhirdar Hamlin Fistula Centre in Ethiopia. Data points used in the analysis included age; parity; length of labor; labor outcome (stillbirth or not); type of fistula; site, size, and scarring of fistula; outcomes of surgery (fistula closed; persistent incontinence with closed fistula; urinary retention with overflow; site, size, and scarring of any rectovaginal fistula; and operation outcomes), and specific methods used during the operation (use of a graft or not, application of a pubococcygeal or similar autologous sling, vaginoplasty, catheterization of ureters, and flap reconstruction of vagina). Primary outcomes were site of genitourinary fistula and persistent incontinence despite successful fistula closure.
RESULTS
The only statistically significant differences between the two groups (P=.05) were a slightly greater need to place ureteral catheters at the time of surgery in women who had not undergone a genital cutting operation, a slightly higher use of a pubococcygeal sling at the time of fistula repair, and a slightly longer length of labor (by 0.3 day) in women who had undergone genital cutting.
CONCLUSION
Type I and type II female genital cutting are not independent causative factors in the development of obstetric fistulae from obstructed labor.

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  • Authors

    Browning A, Allsworth JE, Wall LL

    Source

    Obstetrics and gynecology 115:3 2010 Mar pg 578-83

    MeSH

    Adult
    Case-Control Studies
    Circumcision, Female
    Dystocia
    Ethiopia
    Female
    Humans
    Pregnancy
    Rectovaginal Fistula
    Vesicovaginal Fistula
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    20177289