Fistula Injuries-New Tool Offers Hope for Women

Fistula injuries in women are childbirth-related injuries and Panzi Score tool helps doctors predict the success of surgery and make a path for treating fistula injury.

Treating fistula injuries, a child-birth related injury in women, is still a challenge in poor countries. A team of researchers in Congo have developed a method of scoring fistula injuries that will guide clinicians in determining treatment.

The health care systems in the United States and other industrialized countries have outgrown many of the childbirth-related injuries that are still very problematic in poor countries.

Vesicovaginal Fistula - Causes, Symptoms, Diagnosis, Treatment & Prevention
Vesicovaginal fistula is a gynecological and obstetric problem in females mostly occurs due to complication of a difficult surgery It is an abnormal opening between the bladder and vagina. It may develop due to various causes.

‘In countries where treatment for fistula isn't advanced and health care resources are scarce, a fistula injury in women related to child-birth injury can be a huge problem. A new tool Panzi Score can help clinicians fix the issue.’

One of those is fistula, defined as a hole between the vagina and bladder that causes constant urine leakage through the vagina. In the Democratic Republic of Congo, where treatment for fistula isn't advanced and health care resources are scarce, a fistula injury is potentially catastrophic.

Part of the problem is that doctors don't have a good way to gauge the degree of the fistula injury in order to develop the appropriate treatment plan, said Janis Miller, a professor at the University of Michigan Nursing School and one of the authors of a new study on assessing and treating this injury.

To that end, Miller and her partners in the Congo have developed a method of scoring fistula injuries that will guide clinicians in determining treatment. They can either fix the fistula themselves or refer the woman to a specialist.

Obstetric Fistula - Causes, Symptoms, Diagnosis, Treatment, Prevention, Health Tips
Obstetric fistula, whether a vesicovaginal or rectovaginal fistula, occurs as a result of inadequate care in pregnancy and childbirth. Fistula can be repaired with a simple vaginal surgery.

The tool, called the Panzi Score, will help physicians predict the success of surgery and make a path for treatment, said study co-author Alain Mukwege, a research associate at the U-M School of Nursing.

"If a fistula happens again, there is a greater risk of failure," Mukwege said.

Stem Cell Therapy in Perianal Fistula Associated with Crohn�s Disease
Perianal fistula which is a common complication of Crohn’s disease can now be treated with Darvadstrocel injection for faster healing.

Often, women having difficult labors in developing countries must wait for days for medical treatment, and in the meantime, tissue begins to die. The more tissue death there is, the tougher a fistula is to repair.

The condition can be socially and physically catastrophic for women, Miller said. The women are usually socially isolated and the leakage is acidic and constant, causing horrible sores.

International Day to End Obstetric Fistula 2015
Obstetric fistula is an injury that can leave women physically and socially scarred, leading to incontinence and also, a stillborn baby.

The study included 837 women with fistula injuries who were treated at the Panzi Hospital DRC and its outreach clinics. Fistula severity was assessed and surgical success was ascertained, and researchers analyzed the data to select fistula characteristics predictive of surgical failure.

Miller said the Panzi Score was surprisingly accurate, and she hopes it will be widely adopted.

Source-Eurekalert