Outcome of obstetric fistula repair after 10-day versus 14-day Foley catheterization

Objective: To compare outcome between 10-day and 14-day bladder drainage after obstetric fistula repair. Methods: In a randomized prospective study at Hamlin Fistula Center, Bahir Dar, Ethiopia, patients presenting with obstetric vesicovaginal fistula between 2007 and 2010 were randomized to undergo 10-day (group 1) or 14-day (group 2) postoperative catheterization. Fistulas were categorized via Goh classification. The inclusion criteria were any type of vesicovaginal fistula except circumferential or recurrent. Results: In total, 189 women were enrolled: 107 in group 1, and 82 in group 2. The groups were similar in age, parity, duration of labor, and time from injury to surgical repair. There was no significant difference in fistula stage according to the Goh classification (urethral length, P = 0.3; fistula size, P = 0.9; and vaginal scarring, P = 0.3). There were 3 fistula breakdowns in group 1, and 6 in group 2. The difference in cure was not significant (P = 0.15, confidence interval -0.009 to 0.1). There was no significant difference in non-fistula-related incontinence or urinary retention after repair. Conclusion: The outcome of postoperative catheterization for 10 days was not inferior to that for 14 days. A similar treatment outcome with a shorter duration of catheterization will have a significant impact on reducing infection and cost.