Pre-Operative Urethral Length and Occurrence of Urinary Incontinence Following Vesico-Vaginal Fistula Repair

Abstract

Background: The study was carried out to examine the relationship between preoperative urethral length and urinary incontinence following vesicovaginal fistula repair. Methodology: It was a retrospective case-control study among 23 women who had closed fistula with post-repair incontinence as cases and 32 women who were completely dry as controls. The women had their urethral lengths determined before surgery and were examined for stress incontinence after. Association between categorical variables was determined using Chi-square while the t-test was used to compare the mean urethral length of the cases and controls. A P-value of <0.05 was significant. Results: Women aged 50 years and above had the highest risk of post-repair incontinence. (X2 =9.546, P=0.023). A higher proportion of women who had vaginal delivery developed post-repair incontinence compared with those who had caesarean section (X2 =7.3218, P=0.007). The mean preoperative urethral length among the cases was 1.84+1.22cm while that among controls was 3.52+0.50cm. This difference was statistically significant. (P<0.0001, T=7.0125, SEM 0.239). Conclusion: Reduced pre-operative urethral length, age 50 years and above, and vaginal delivery are all associated with post-repair urinary incontinence.