Project Background
An obstetric fistula is an abnormal opening between the bladder and the vagina that results in continuous urinary incontinence. These openings develop during obstructed labor when the fetal head presses against the pelvic bone during the mother’s contractions, leading to a loss of blood flow to the soft tissue in that region (Figure 1). The resulting tissue death leaves a hole in the tissue, known as a fistula, between the mother’s birthing canal and either the bladder or rectum. This project focuses specifically on vesicovaginal fistulas (VVF), which are abnormal openings between the birth canal and the bladder. Women living with this birthing injury often experience ostracism, stigma, shame, and partner rejection due to the constant wetness, frequent urinary tract infections, and odor.
While this condition is rare in developed countries due to access to cesarean sections and other emergency health care, it is extremely prevalent in Africa and South Asia where access to emergency maternal health services is limited. More than 100,000 women develop obstetric fistulas each year in these regions. However, less than 20,000 fistula closure surgeries are performed each year. Thus, there is a large need for technology that allows the 2-3 million women suffering from this birthing injury as well as those who develop it each year to manage their incontinence, which would allow them to reenter society and preserve their self-esteem and wellbeing.
Need Statement
Women with obstetric vesicovaginal fistulas (VVF), abnormal openings between the bladder and vagina that result from prolonged and obstructed labor, need a way to reenter society without experiencing extreme humiliation, isolation, and stigma due to uncontrollable leakage of urine through the genital tract.
Our Solution
The final solution is a reusable biker short with a built-in urine collection cup that aligns with the user’s vulva to allow urine leakage from the genital tract to funnel into the cup. The liquid then flows through a flexible tube into a urine bag housed in a pocket on the thigh of the shorts. This design scheme is depicted in Figure 2. The biker shorts are high waisted to help support the wearer’s pelvis, where vaginal tissue and muscles may be weakened due to prolapse. Further, the performance spandex/nylon blend they are made of provides proper compression and maximal comfort. Additionally, the pocket and tubing tract are fully lined with an antimicrobial, moisture-wicking fabric.
The external collection cup is a shallow silicone funnel that molds to the user’s vulva and is aligned with the center crotch seam of the shorts. This center area is also surrounded with the moisture barrier to control the smell and collect excess urine. Connection to the tubing through the shorts allows for a seamlessly integrated design.