Patients at the Addis Ababa Fistula Hospital in Ethiopia are all treated free of charge. Surgery The nature of the injury varies depending on the size and location of the fistula, so a surgeon with experience is needed to improvise on the spot. Before the person undergoes surgery, treatment and evaluation are needed for conditions including anemia, malnutrition, and malaria. Quality treatment in low-resource settings are possible (as in the cases of Nigeria and Ethiopia). Treatment is available through reconstructive surgery. Primary fistula repair has a 91% success rate. The corrective surgery costs about US$100–400, and the cost for the entire procedure, which includes the actual surgery, postoperative care, and rehabilitation support, is estimated to cost $300–450. Initial surgeries done by inadequately trained doctors and midwives increase the number of follow-up surgeries that must be performed to restore full continence. Successful surgery enables women to live normal lives and have more children, but it is recommended to have a cesarean section to prevent the fistula from recurring. Postoperative care is vital to prevent infection. Some women are not candidates for this surgery due to other health problems. In those cases, fecal diversion can help the patient, but not necessarily cure them. Besides physical treatment, mental health services are also needed to rehabilitate fistula patients, who experience psychological trauma from being ostracized by the community and from fear of developing fistulae again. A study on the first formal counseling program for fistula survivors in Eritrea shows positive results, whereby counseling significantly improved the women's self-esteem, knowledge about fistulae and fistula prevention, and behavioral intentions for "health maintenance and social reintegration" following surgery. Challenges Challenges with regards to treatment include the very high number of women needing reconstructive surgery, access to facilities and trained surgeons, and the cost of treatment. For many women, US$300 is a price they cannot afford. Access and availability of treatment also vary widely across different sub-Saharan countries. Certain regions also do not have enough maternal care clinics that are equipped, willing to treat fistula patients, and adequately staffed. At the Evangelical Hospital of Bemberéke in Benin, only one expatriate volunteer<unk> s and gynecology doctor is available a few months per year, with one certified nurse and seven informal hospital workers. In all of Niger, two medical centers treat fistula patients. In Nigeria, more dedicated health professionals operate on up to 1,600 women with a fistula per year. The world is currently severely under capacity for treating the problem; it would take up to 400 years to treat the backlog of patients. To prevent any new cases of<unk> e, about 75,000 new emergency<unk>  care facilities would have to be built in Africa alone, plus an increase in financial support and an even higher number of certified doctors, midwives, and nurses needed. Another challenge standing between women and fistula treatment is information. Most women have no idea that treatment is available. Because this is a condition of shame and embarrassment, most women hide themselves and their condition and suffer in silence. In addition, after receiving initial treatment, health education is important to prevent fistulae in subsequent pregnancies. Another challenge is the lack of trained professionals to provide surgery for fistula patients. As a result, nonphysicians are sometimes trained to provide<unk>  services. For example, the Addis Ababa Fistula Hospital has medical staff without formal degrees, and one of its top surgeons was illiterate, but she had been trained over years and now regularly successfully performs fistula surgery. Catheterization Fistula cases can also be treated through urethral catheterization if identified early enough. The Foley catheter is recommended because it has a balloon to hold it in place. The indwelling Foley catheter drains urine from the bladder. This decompresses the bladder wall so that the wounded edges come together and stay together, giving it a greater chance of closing naturally, at least in the smaller fistulae. About 37% of<unk> e that are treated within 75 days after birth with a Foley catheter resolve. Even without preselecting the least complicated<unk>  cases, a Foley catheter by midwives after the onset of urinary incontinence could treat over 25% of all new fistulae.
Obstetric fistula
Lymphocele
Vaginal stenosis
Vesicouterine fistula
Urethrovaginal fistula
Cystocele
Uterine prolapse
Urogenital fistula