Iatrogenic Fistula

Sometimes genital fistula can be caused unintentionally by a health care provider. This type of injury is called iatrogenic fistula. For instance, during a cesarean section, it is possible that the bladder is accidentally cut, resulting in a hole or abnormal opening through which urine leaks.

Iatrogenic fistula can also occur by accident during surgeries unrelated to childbirth. In many of the countries where we work, approximately 10-15% of the overall patient caseload is due to iatrogenic causes. Training surgeons and other health care staff in emergency obstetric care and other surgical skills is essential to preventing new cases of iatrogenic fistula.

Related Resources

Iatrogenic Fistula: An Urgent Quality of Care Challenge. Fistula Care Plus technical brief, August 2016. Evidence is emerging that maternal morbidity is related to quality of care challenges: Iatrogenic causes appear to contribute significantly to the burden of genital fistula in low-income countries. Fistula Care Plus has sought to raise awareness about this important issue, documenting current trends and perceptions related to iatrogenic fistula and identifying actions that partners can take to address the problem.

Frequency and management of non-obstetric fistula in the Democratic Republic of Congo: Experience from the Fistula Care Plus project. Trop Med Int Health, June 2020. In order to describe the frequency, causes and post‐repair outcomes of non-obstetric fistula (NOF) in hospitals supported by the Fistula Care Plus (FC+) project in the Democratic Republic of Congo, FC+ staff and partners conducted a retrospective cohort study from 1 January 2015 to 31 December 2017 in three FC + supported fistula repair sites. Of 1984 women treated for female genital fistula between 2015 and 2017 in the three FC + supported hospitals, 384 (19%) were considered to be NOF cases.

Webinar: “A Call to Action to End Iatrogenic Fistula”– Aug 17, 2016. Evidence is emerging that iatrogenic causes contribute significantly to the burden of genital fistula in low-income countries. Given the preventability and severity of fistula, data on iatrogenic fistula indicate the urgency of improving surgical training, supervision, and facility capacity, particularly amid increasing rates of cesarean section and gynecologic surgery in low-income countries. While data indicate the need for a consistent definition of iatrogenic fistula, people working on these issues have yet to reach a consensus on definitions or a minimum acceptable standard of surgical care in low-income countries. During the webinar, moderator Bethany Cole and presenters Dr. Lauri Romanzi and Dr. Vandana Tripathi aimed to further the global effort to address these important issues.

Fistula Care Plus panel “Iatrogenic fistula: New Landscape, Emerging Challenges confront fistula care programs” at the 2015 Global Maternal and Newborn Health Conference in Mexico City

“Iatrogenic Fistula on the Rise as More Women Gain Access to Surgery”- Blog post by Sandeep Bathala, Senior Program Associate, Wilson Center Maternal Health Initiative