Waaldijk classified fresh obstetric fistulas based on a number of features important to the surgeon. The author is from the Murtala Muhammad Specialist Hospital in Kano, Nigeria.
Parameters:
(1) involvement, especially relative to the urethral closing mechanism (sphincter)
(2) size
Uretheral Sphincter
Other
Type
not involved
none
I
involved
none
II
involved with partial involvement of urethra
none
IIA
involved with total or subtotal involvement of urethra
none
IIB
NA
fistula involves ureter or other site
III
Subtypes for IIA and IIB
Finding
a
without a circumferential defect
b
with a circumferential defect
where:
• A circumferential defect indicates a complete separation of the urethra from the bladder.
Size classification:
(1) small
(2) medium
(3) large
(4) extensive
Clinical severity increased as the type increases from I to IIB. Type III are rare and harder to generalize.
To read more or access our algorithms and calculators, please log in or register.
