A training phantom for a vesicovaginal fistula repair with the transvaginal approach

It is estimated that in Africa 30,000-130,000 new cases arise annually and a total of 3 million women suffer from untreated vesicovaginal fistulas (VVFs) in Low- and Middle-Income Countries (LMICs) worldwide. A VVF is an abnormal communication between the bladder and vagina that can result in urine leakage through the vagina. This does not only lead to physical but also psychological problems. In LIMCs, the most common cause of a VVF is obstructed labour. Early childbearing (before full pelvic growth is achieved), poor socioeconomic status, low literacy rate, malnourishment, inadequately developed infrastructure for health care for pregnant women and lack of access to emergency obstetric services are factors that impact the high rate of cases in LIMCs. Some of the consequences are stigmatization and social isolation, because obstructed labour is often seen as a punishment from God and patients are abandoned by their families because of the smell of urine. [...]