For many women, 7 days of postoperative bladder drainage is probably sufficient.
In developing countries, where genitourinary (GU) fistulas are common, 90% result from prolonged labor. Conversely, in developed countries, 90% of GU fistulas are caused by injury during pelvic surgery (mainly gynecologic). Regardless of etiology, the same surgical strategies are used to manage GU fistulas.
Researchers in sub-Saharan Africa conducted a randomized noninferiority trial to evaluate 7 versus 14 days of postoperative bladder catheterization after obstetric fistula repair in 501 women. Fistula diameters ranged from 0.1 to 6 cm; more than half were midvaginal, juxta-urethral or urethral in location. Rates of repair breakdown were similar in the 7-day group and the 14-day group (4% and 3%, respectively; risk difference, 0.8%; 95% co…