Difficult Surprises of Obstestric Fistula Treatment

 Undergoing a fistula reconstructive surgery and healing are two different things. I realised one surgery doesn’t always guarantee healing. When I was newly admitted to the hospital one woman cried bitterly during the ward round when she was told to go home and come back after two months for another surgery. This was her second surgery and the leaking urine had not stopped. She painfully asked me how she would go back home after two months of hospitalization and still leaking urine yet people knew she came for treatment? She struggled to go back home to be a burden to his brother since she was separated from her husband after she lost her baby and developed a fistula. She also closed her business due to fistula. It was better for her to stay in the hospital where she is assured of three meals and two snacks a day, diapers and she doesn’t need to strain herself or bother people to take care of her. 

Most women who undergo surgery to deal with leaking urine stay with one, two, or three catheters for at least 14 -21 days to allow healing depending on the severity of the fistula. I stayed with a catheter for 14 days after the surgery. When you have the catheter it's a critical time when you realise the importance of taking water. I had been counting and waiting for my 14th day after surgery as my hospital stay had been long overdue, I initially thought I’d undergo only the surgery to deal with leaking stool which takes at least 5 days. However, after the surgery, I was informed by the team of doctors that they did both the stool and urine reconstructive surgery. I was however not surprised since I would experience urine leakage when doing exercises when I sneezed or coughed, and when I skipped a rope I would be all wet and would mostly do this when alone to avoid embarrassment. I remember I once had to discontinue going to the gym because of this. I would tie a jumper on my waist so that people do not realise I am wet.

So finally it was my 14th day, that morning I went to the hospital chapel alone to thank God for my healing journey. I was very excited and looking forward to going home healed. I even take a last photo with my catheter. The previous day the nurse who was dressing the wound told me after they removed the catheter, one had to be observed for one or two days to watch for urine retention or any complications. You know that’s another story, if a woman giving birth thinks that “kupima njia” that is seeing how dilated one is, is embarrassing…when you are a fistula patient they dress the wound twice to check on the recovery process which is quite uncomfortable but part of the treatment.

So it's finally my turn. My wound is dressed then a doctor removes the catheter. I am so happy. I take a lot of water. I managed to relieve myself without a catheter twice but the third time after taking a lot of water, I developed urine retention, and urine “refuses” to come out. I am in a lot of pain. Luckily the doctors were doing the ward rounds. The doctors had to quickly think of an intervention since urine retention is very painful…from my experience, I can compare it with labour pains.  I felt like a case study since urine retention doesn’t occur in all patients.  I cried painfully, I was looking forward to going home to be with my children.

I experienced what one scholar calls a negative religious experience that obstetric fistula patients go through. I felt like I had added myself more trouble than what brought me to the hospital. I however never doubt my God regardless of the experiences I go through since I am always asured of His Presence with me.I however felt embarrassed that in the morning I prayed and thanked God for His healing but I had to stay in the hospital longer. The other patients were a bit scared ( maybe fearing that also happens to them)  but also really encouraged me. 

The doctors told me that they would do bladder training. (It’s a short catheter, the difference is that this time one can feel the urine, then remove a syringe that blocks it. One doctor when training me how to use the new catheter joked that the next week you'll relieve yourself like a man. I was to do this for seven days, then remove the catheter and see if the bladder could function by itself.  The doctors however told me that it is not a guarantee that after the bladder training and the catheter is removed I will have recovered. If I did not they said I would be discharged on self-catheterisation and come back for another surgery.

This was quite disappointing. I was not ready to stay in the hospital longer or do bladder training yet I had urine retention and they had to remove urine manually four times with a catheter after a lot of pain. I somehow had faith that the urine would come. I remember going to the toilet to pray while holding my lower bladder tummy and commanding the urine out but it didn't. I didn’t know God had a different plan to expose me to the struggles of fistula patients.

Three doctors talked to me for almost two hours, they first listened to me and finally showed me how I should be grateful and I finally accepted to have the second catheter. At that point, I discovered that there are very serious cases of fistula. One doctor said some women you see here have no vaginas and live in extreme poverty. Some patients use stool stomas, where they collect stool in a bag. Others are still on self-catheterization (this is not easy yet some fistula patients live this way after medical interventions which is better than leaking urine). They also told me fistula is a condition that doesn’t require stress which could be causing the urine rentation. They even tried to enquire if something was bothering me. I said no but at that point, I had my deep struggles which I could not share.  

Thankfully by God’s grace after the catheter was removed the urine came naturally. I was a bit anxious but I had informed a few friends and my parents and prayer partners to pray with me. This taught me to be grateful for bodily functions like being able to hold and release urine for granted.

As I conclude my sharing my fistula journey, I will share about six months post fistula surgery. In a few days, it will be six months after my fistula surgery which is very critical for the healing journey of any fistula patient.