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'Obstetric fistula is one of the most devastating forms of maternal morbidity. The condition tends to affect relatively young women after their first pregnancy. The successful repair of an obstetric fistula can be life changing and in many cases the repair allows the woman to participate in social activities from which she has been previously excluded. This month’s issue features a paper by Anzaku and colleagues from Jos, Nigeria. The authors conclude that after a fistula repair, sexual dysfunction is a major problem. Over 75% of the women in their study resumed sexual intercourse after successful surgery and over 60% of the 102 eligible women had some form of sexual dysfunction. The authors highlight the need for management of sexual dysfunction to be integrated into patient care after successful obstetric fistula surgery.'