Experts reconvene in Addis Ababa Fistula Hospital to advance management of post obstetric fistula repair incontinence (POFRI)
From 28 July to 1 August 2025, global leaders in fistula surgery gathered once again at Addis Ababa Fistula Hospital in Ethiopia for the FIGO Expert Surgical Workshop, jointly hosted by the FIGO Fistula Surgery Training Initiative (FSTI) and Hamlin Fistula Ethiopia (HFE). Building on the momentum from the 2024 event, this year’s workshop continued its dedicated focus on the persistent challenge of ongoing urinary incontinence following vesicovaginal fistula (VVF) repair, a complication that affects many women post-repair.
The FIGO FSTI team and Dr Andrew Browning, FIGO trainer and world-renowned fistula surgeon, once again chaired the two-day Expert Advisory Group (EAG) meeting followed by the three-day POFRI workshop, which brought together international expert surgeons to discuss innovative surgical interventions and to share research on approaches for POFRI, as well as appropriate conservative management pre- and post-repair.
Each morning began with presentations and discussions by experts, followed by patient examination and theatre preparation of surgical demonstrations of key procedures addressing complex incontinence in the afternoon. Notably, participants observed techniques including:*
- Bulking agent use by Prof Judith Goh and Prof Hannah Krause, as well as Dr Michael Breen and Dr Larry Sirls
- Anterior bladder neourethra creation by Dr Andrew Browning
- Bladder neck reconstruction with Dr Igor Vaz
- Mitrofanoff procedures by Dr Hillary Mabeya
- Ileocystoplasty (Maputo modification) by Dr Igor Vaz
- Neovagina procedures led by Dr Fekade Ayenachew
- the innovative Singapore flap and sling technique.
Afternoons featured in-depth group discussions, fostering a collaborative environment for reviewing clinical outcomes, refining strategies and discussing next steps based on live observations. Experts examined outcomes from three pilot groups initiated in 2024 and aligned on advancing consensus around the POFRI care pathway, including the FIGO Expert Opinion Paper and accompanying flowchart, presented by Prof Judith Goh.
The programme's EAG also convened prior to the workshop on 28–29 July 2025, reviewing the current FIGO training programme, together with key criteria training status, fistula surgery equipment updates, country mappings and future planning collaborations.
Surgical presentations from the expert surgical workshop in Addis Ababa will soon be available via the Fistula resource hub.
* Please note: the procedures mentioned in the article above and demonstrated by expert surgeons in the presentations are still in the research stage and are not to be used in practice.