Forty-one women with OUF were seen during the study period (Table I).
With an annual delivery rate of approximately 100 000 in KZN, the frequency of OUF in the present survey is low compared with that reported from other countries in Africa such as Nigeria, where the reported fistula rate is 350/100 000.
Traditional surgical practices have also been reported to play a role in the aetiology of OUF.
There is concern that morbidity, including OUF, and maternal mortality may increase with greater numbers of CSs being performed in under-resourced countries, before provision of proper surgical training, adequate infrastructure and well-trained support staff.
This is supported by other studies (25,26) and has resulted in liberal use of these flaps in the surgical treatment of OUF at KEH.
Although this is a descriptive study, it identified areas in KZN and Eastern Cape where OUF is prevalent, described the patient profile, and provided an audit of surgical interventions and outcomes.
For descriptive purposes OUFs were categorised into simple VVF, complicated VVF, and vesico-uterine fistulas.