General objective
To study the outcome of surgical repair and the socio-demographic features of fistula patients in Abbu fistula center at Khartoum Teaching Hospital 
Specific objectives
To determine the success rate of surgical repair of obstetric fistula  at Abbu fistula center at Khartoum Teaching Hospital 
To determine patient characteristics, associations, and determinants of successful surgical repair in Abbu fistula center at Khartoum Teaching Hospital 
To identify the associated risk factors of fistula among Sudanese women at Abbu  fistula center.
Hypothesis
There is a trend in characteristics described for the fistula patient population in low-income countries. The patient with obstetric fistula typically is of short stature and young age; is extremely poor, divorced, and a primigravida; and has an index labor lasting more than 2 days. The first attempt at repair is most successful, with rates of closure approaching 90%; early surgical repair after injury also improves success. Fistula represented one of the most common reasons for referral to gynecological fistula centers. Although it is worrying symptom, I think now is high time to do research and work to see the magnitude of the problem aiming better cure and good outcome and to stand on solid background against fistula

Methods: 
It was descriptive  cross section study, conducted in Abbu fistula center, Khartoum Teaching Hospital- Khartoum state (Sudan) during the period from August 2019 to August  2021. The study sample was 176 women underwent fistula repair and fulfilled the inclusion criteria of the study. Data was collected using a questionnaire which filled with women after taking informed consent.

The common age group was 20 – 29 years (30.3%), followed by less than 20 years (26.3%), above 39 years (25%) and 30 – 39 years
(18.4%) 
Most of the women (60.5%) from rural areas, and (39.5%) from urban areas 
Laborers were (48.7%), housewives (47.4%) and employees were (3.9%) 
Para 1 to 5 were (23.9%), para more than 5 were (27.6%) and para 0
were (18.4%) .
Previous abortions (1 – 3) reported in (46.1%) and (53.9%) of the women had no previous abortions .
In (61.9%) of the women no co-morbidities. The co-morbidities were diabetes (18.4%), hypertension (11.8%) and diabetes with hypertension (7.9%) 
The mode of current delivery was spontaneous VD (42.1%), assisted VD (31.6%) and cesarean section (26.3%) .
The stratification of risk factors of obstetric fistula came as follow: rural residence (60.5%), precious abortions (46.1%), delivered by assisted vaginal delivery (31.6%), multiparty (27.6%) and age group less than 20 years (26.3%) (P value < 0.05) .
The types of fistula were type 1 (59.2%), type 2a (17.1%), type 2b (14.5%) and type 3 (9.2%) .
The number of repairs was one (first time) in (75%) and more than 1 (tried before) (25%) .
The duration of operation was less than 24 hours (39.5%), 24 – 47
hours (26.3%), more than 72 hours (26.3%) and 48 – 72 hours (7.9)
 
The success rate of operation of fistula repair was (61.8%) and failure (38.2%) .
The factors increased success rate were low parity, no previous history of abortions, no comorbidities, type 1 fistula, first time repair and shorter duration of operation (P value < 0.05)

The common age group was 20 – 29 years (30.3%). Most of the women (70.5%) from rural areas. The stratification of risk factors of obstetric fistula came as follow: rural residence (70.5%), obstructed labour  (46.1%), delivered by assisted vaginal delivery (31.6%), PG 21(27.6%) and age group less than 20 years 20(26.3%) (P value < 0.05). Young women with some primary or no education and prolonged labor at the time of first delivery were most highly correlated with obstetric fistula formation. Success of fistula closure was 81.3% for first-time vesicovaginal fistula (VVF) repairs and 91.6% for first-time combined vesico-vaginal and recto-vaginal fistula (VVF/RVF) repairs. Among women who had previously attempted VVF repair, 73.6% of fistulas were repaired successfully, but the 2 cases of combined fistula were unsuccessful.

Among Sudanese  women presenting for fistula repair, fistula was highly correlated with a low level of education and prolong and obstructed  labor. The findings are consistent with results reported from other countries in Sub- Saharan Africa.