Obstetric Fistula Advocacy Group

NOTE:

If you have a Rectovaginal Fistula (RVF) seek the opinion from a Colorectal Surgeon (CRS)

If you have a Vesicovaginal Fistula (VVF) seek the opinion of a Urogynaecologist or Surgeon with specialist obstetric fistula training in Africa.

THIS IS THE NUMBER 1 RULE – Make sure they have experience and successful obstetric fistula repairs (don’t be afraid to ask them). Don’t go near anyone that doesn’t.

Obstetric Fistulas are surgical specializations that require on-the-job experience. This experience can only be gained from working or volunteering in developing countries where there is a high incidence of these fistulas.

The nature of the location of both recto and vesico fistulas means that the more surgeries you have to repair the more they are likely to fail. So make the first repair count, even if it means delaying surgery.

Make sure you have a competent surgeon with the experience you need for a successful repair.

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1. Where was their experience gained and what fistula repair do they specialise in?
2. How big is the fistula?
3. Where is the fistula located – in the bladder or the bowel?
4. Ask what type of surgery you will be having and what it will involve eg: pre surgery tests, required length of time in hospital, after surgery care, time off from work and family commitments.
5. What is the nature of the repair you are doing? (flap surgery, labial fat graft etc) Skip this question if you’ve never had a repair- If he/she is planning on doing a repair that has failed on you, ask the success rate of the surgery, and why they feel this particular surgery will work for you this time, since it has previously failed.
6. What type of prep will I need? (diet, bowel prep, fasting)
7. What are the possible long-term complications. Whilst many ladies are frightened to ask this question, it is important to broach this subject so you know right from the outset. This knowledge will allow you time to research and be fully aware of your rights as a patient.
8. What is your (the surgeons) personal success rate with this surgery?
9. What do you (the surgeon) feel my chances of being healed with this surgery are?
10. How long will my recovery be?
11. How long should I avoid lifting?
12. What should I do if I notice infection or leakage after surgery?
13. What about pain management?
14. Will I / Can I be admitted to the hospital for my surgery?
15. Will I be put on antibiotics after my surgery to prevent infection? And for how long?
16. How do I care for my wound?
17. Are Sitz Baths ok? If so, when?
18. What type of diet should I be on after surgery?

     

    Always seek a second opinion, and don’t ever be afraid to seek a third or fourth opinion if required.

©Obstetric Fistula Advocacy Group 2023