Obstetrics & Gynaecology · Prolapse, Urinary Incontinence and Fistulas

A 30-year-old woman with obstructed labor develops continuous urinary incontinence. On examination, the fistula is located at the bladder neck with involvement of the proximal urethra. According to the Goh classification, this is classified as type:

  • A Type 1
  • B Type 2
  • C Type 4
  • D Type 3
Correct answer: C. Type 4

Explanation

Goh's classification of obstetric fistulas: Type 1 is >3.5 cm from the external urethral meatus (EUM); Type 2 is 2.5-3.5 cm; Type 3 is 1.5-2.5 cm; Type 4 is <1.5 cm from the EUM (involving the bladder neck/urethra). Type 4 fistulas are the most challenging to repair due to involvement of the continence mechanism. This classification guides surgical approach and predicts outcomes.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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