Urogenital Fistula: Still a Major Morbidity in Developing Countries
Objective: To revisit the trend of the frequency of reported cases of fistula in Pakistan.
Methodology: This quantitative retrospective study was conducted at the MCH Fistula Center, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from February 2021 to September 2021. After getting ethical approval, the record rooms were sought from the centers dealing with fistula patients, including all the available data for the twelve-year window period (2006–2018). Data was retrospectively collected by researchers using a predesigned study proforma and analyzed through SPSS software 25.0.
Results: Overall, 2621 reported cases of fistulae were included in this study, making an average yearly frequency of 218 cases/year. The mean age of patients suffering from fistula was 34.62 + 10.2 years. Ninety-six percent of patients were illiterate and 94.7 % belonged to the poor class. Forty-two percent of cases were from Punjab followed by Sindh (33.5 %). Forty-six percent of the cases had a duration history of having fistula of last 6 months, followed by 23% of cases coming with duration between 6-12 months. Most common reported cases were vulvovaginal fistulae (78.4%).
Conclusion: Despite being in 21st century with improved health care facilities, there are still reported cases of fistulae which add to the poor quality of life to these women. Much more worrisome are the unreported cases who never reach health care facilities get their issues addressed. There has been a decreasing trend in reported cases of fistulae over the years. The government of Pakistan needs to take measures to strengthen existing public health facilities as well as ensure that there is equitable access to health care for fistulae diagnosis and management across Pakistan.
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