Urinary incontinence after prolonged labour and caesarean section
A 30 year old woman, who had had five children and two abortions, presented to the outpatients' department with a one year history of constant dribbling of urine after her last delivery. This was a caesarean section after a prolonged obstructed labour. The baby had a transverse lie and a two day history of an impacted shoulder and hand prolapse. He had a subsequent intrauterine death.
Management of obstetric fistulas involves identifying the site of the fistula followed by corrective surgery, on the basis of the history, examination, and further investigations.