Experience of uetropubic urethrolysis and sling operation for the treatment of post fistula repair residual incontinence at the Addis Ababa Fistula Hospital, Addis Ababa Ethiopia.

BACKGROUND

Incontinence after successful closure of fistula is a very challenging problem. Neither the cause nor the optimal treatment is well established Biological slings are still the option of treatment in the developing world whereas in the developed world they are substituted by synthetic meshes.

OBJECTIVE

The study aims to asses outcomes of retro pubic urethrolysis and sling operation in the treatment of post fistula repair incontinence.

METHODOLOGY: This study is a cross-sectional descriptive study done in Addis Ababa Fistula Hospital. A total of 56 patients who under went retro pubic urethrolysis and sling operation were analyzed.

RESULTS

The study showed that the over all success rate of the operation is 73.2%. However complete cure was achieved in only 41.1% of the cases. Bothersome urinary retention was seen in 8.9% of cases. In more than one third of the cases there were post operative complications.

CONCLUSION

Biological sling is effective in the treatment of post fistula repair incontinence. It has comparable results to that of synthetic slings when used in patients with fixed urethra and intrinsic urethral sphincter deficiency. However it is imperative to see the long term results. Moreover, Urodynamic examination for patient selection and measures to reduce infection are recommended.