Operated genital fistulas in Yaoundé, Cameroon: clinical characteristics and surgical outcomes

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Abstract Introduction Female genital fistula remains a major cause of incontinence, stigma and disability in Sub-Saharan Africa (SSA). This study aimed to describe the epidemiological, clinical and therapeutic characteristics of women operated on for genital fistula in two surgical centres in Yaoundé, Cameroon. Materials and methods We conducted a descriptive cross-sectional study combining a retrospective review of medical records (women operated between 2019 and 2020) and a prospective follow-up interview (conducted 7–28 January 2021, at least six months after surgery) at the Yaoundé University Teaching Hospital and the Essos Medical and Surgical Center. Women operated for genital fistula between 2019 and 2020, living in Cameroon and consenting to participate, were included. Data were analysed using Epi Info 7.2.2.6 and reported as counts, percentages, and medians with interquartile range (IQR). Results Fifty-four women were included; the median age was 33 years (IQR 28–40). Fistula surgery represented 5.6% of operating-room activity at the Yaoundé University Teaching Hospital. Half of the women (50.0%) had no income-generating activity. Median parity was 2 (IQR 1–5). Obstetric aetiology was predominant (42/54; 77.8%). The median duration of living with fistula was 2 years (IQR 1–8). Rectovaginal fistulas accounted for 30/54 cases and vesicovaginal fistulas for 24/54 cases. Fistula closure was achieved in 49/54 women (90.7%), and 43/49 closures were continent (87.8%). No woman underwent a formal psychological assessment by a trained professional; during the interview, 5.6% self-reported suicidal ideation and 12.9% reported living in isolation at some point while living with the fistula. Conclusion Surgical outcomes approached the WHO’s international benchmark for fistula repair programmes, but structured psychosocial and economic support was entirely absent. Integrated fistula care should combine obstetric prevention, timely surgery, and systematic reintegration support.