Childbirth is increasingly being recognized as commonly injuring the mother's anal sphincter complex. Fecal incontinence also appears to be associated with urinary incontinence and pelvic organ prolapse. Anal continence does not completely depend on intact sphincters; also important are intact neuromuscular function, including a functioning puborectalis muscle and pudendal nerve. This is supported by the fact that some women with sphincter lacerations remain continent. Anatomical knowledge of the anorectal canal is essential. Complications of anal sphincter laceration include anal incontinence, fecal urgency, perineal pain, and sexual dysfunction. Diagnostic studies, non-invasive therapies, and surgical management have all evolved in recent years. This has resulted in an improving outlook for women with this stigmatizing condition.Read More

Obstructed labor remains the most important cause of vesicovaginal fistulas in developing countries. Absent or untrained birth attendants, reduced pelvic dimensions (caused by early childbearing, chronic disease, malnutrition, and rickets), uncorrected inefficient uterine action, malpresentation, hydrocephalus, and introital stenosis secondary to tribal circumcision all contribute to obstructed labor. The purpose of this document is to explore various surgical techniques for surgical repairs of lower urinary tract fistulas. Obstetric fistulas are characterized by considerable necrosis, sloughing, tissue loss, and cicatrisation. Vesicovaginal fistulas commonly occur in the setting of wide range of other immediate problems, such as stillbirth, ruptured uterus, third- or fourth-degree perineal lacerations with resultant rectovaginal fistulas and anal incontinence, and pelvic infection. In modern obstetrics, most of these conditions do not exist. Generalists should be trained to repair simple fistulas, with referral of complex cases to specialized fistula hospitals.Read More

Obstetrical fistulae are the most devastating healthcare problem for women globally. In modern obstetrics its existence is negligible, yet each year over half a million women die of complications of pregnancy, childbirth or unsafe abortion. The vast majority of these deaths are in developing countries. For every woman who dies in childbirth, 30 to 50 women suffer injury, infection or disease. About 1 million women in the world suffer from obstetrical fistulae. Pregnancy related complications are among the leading causes of death and disability for women age 15-49 in developing countries. This is not a problem of developing countries only; it is about human beings in distress and pain. THE BEST TREATMENT & MANAGEMENT OF OBSTETRICAL FISTULAE IS PREVENTION.Read More

Loss of control of urine, gas and stool can have a significant impact on the social well-being of affected women. It is a social and hygienic problem and leads to social distress. Urinary and fecal incontinence and related psychosocial distress constitute a spectrum related to the actual severity of the loss of control and to the woman's perception of her disability. Great stigma and shame is associated with urinary and fecal incontinence. The purpose of this document is to provide a better understanding of this devastating situation and provide management. Forums and management guidelines hope to provide the incentive for social and psychological programs to help women who are unfortunate victims of the situation.Read More