The present study revealed that in the DRC, the failure rate of surgical repair of obstetric vesico-vaginal fistula is less than twenty-five percent of all treated participants. The study developed a score to predict the risk of surgi- cal repair failure, with factors including the number of fistulas greater than or equal to two, fistula size greater than three centimeters, presence of fibrosis (scarring), association with other fistulas, peri-operative haemor- rhage and post-operative infection. There is a need to develop a more advanced therapeutic approach that takes into account such risk factors as predictive indicators for failed surgical repair. Once validated, the predictive score will help implement a pre-operative participant counsel- ling and surgical management regimen tailored to each case of obstetric vesico-vaginal fistula. All this will help improve the outcome of surgical management of obstet- ric vesico-vaginal fistulas in the DRC and ultimate well- being of fistula women.