Obstetric fistula, which develops after a difficult childbirth, leads to continuous urinary and fecal incontinence, and can cause devastating physical and mental suffering for millions of women in developing countries. Although surgical treatment options are available, little is known about the long-term prognosis of such procedures and a vast majority of women suffering from fistula do not even have access to surgical repairs.

Johns Hopkins University, in collaboration with medical and national institutions in seven high fistula-prevalent countries, propose to undertake a multi-country study to examine post-operative prognosis, improvement in quality of life, social integration, and rehabilitation of fistula patients after surgical treatments. The current fistula classification systems are based on anatomical descriptions and have never been validated for prognostic outcomes. The study data will be further utilized for developing a standardized classification system that allows the predictability of prognosis. The standardized classification of fistula would help in describing epidemiology according to severity, devising type-specific treatment protocols, assessing training needs for surgeons, and allocating limited medical resources for the optimal care of fistula patients in resource poor settings.