OBSTETRIC FISTULA(vaginal fistula)

Obstetric fistula is a severe medical condition in which a fistula(hole) develops between either the rectum and vaginal or between the bladder and vaginal after severe or failed childbirth,when adequate medical care is not given
SYMPTOMS AND SIGNS
Resulting disorders typically are incontinence,severe infections and ulcerations of the vaginal tract and often paralysis caused by nerve damage.sufferers of this disorder are subject to severe social stigma due to odor,perception of uncleanliness,mistaken assumption of veneral diseases and in some cases the inability to have kids

CAUSES
Develops when a prolonged labor presses the unborn child so tightly in the birth canal that blood flow's cut off from the surrounding tissues which necrotise and eventually rot away.The injury's rarely caused by female genital cutting,poorly performed abortions or pelvic fractures.potential direct causes are sexual abuse and rape,other surgical trauma,gynecological cancers or other related radiotherapy treatment,limited or no access to obstetrical care or emergency services.Distal causes are poverty,early marriage and childbirth,harmful traditional practices,nonavailability and nonaccess to medical faclities with trained staff and specialized surgical equipments needed for cesarean births.early or closed spaced pregnancies,female genital mutilation,lack of education,malnutrition linked to underdevelopment of female body and no personal knowledge about and experience with childbirth may cause obstetric fistula

PREVENTION
Its prevented by providing access to obstetric care,support from trained healthcare professionals throughout pregnancy,providing access to family planning,promoting practice of spacing between births and supporting women in the education and posponing early marriage.prevention of obstructed prolonged labor and fistula should preferably begin as early as possible in each female's life(eg improved nutrition).Access to timely and safe child delivery and educating girls can help avoid fistula

TREATMENT
It is available through reconstructive surgery as it helps women to live normal lives and have more kids,but it's recommended to have a cesarean section to prevent fistula from reoccuring.post-operative care prevents infection.Girls not candidates to surgery can resort to urostomy and a bag for the colection of urine is worn on a daily basis.the largest challenge's that most women have no idea fistula's treated.because it's a condition of shame and embarrassment most women hide themselves and their condition and suffer in silence with no relief.with treatment,women rejoin their families without shame from their condition for the leaking and smell are no longer there.urethral catherization is also useful.
PROGNOSIS
if left untreated,ulcerations and infections can persist as well as kidney disease & kidney failure leading to death.urinal & fecal leaking persist.due to constant leaking and smell,women are descriminated against.