A New Classification of Female Genital Fistula

Tafesse, Biruk

doi:10.1016/s1701-2163(16)32823-7

Cited by 11 publications

(8 citation statements)

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“…Moreover, continuous bladder drainage through folly catheter helps the bladder repair to heal without distension and reduces the risk of infection, breakdown of repair and patient's hospital stay. Since recovery after surgery generally takes two weeks, patient's bladder needs drainage through a catheter traditionally for two weeks [32,46,47]. This is also in agreement with the findings of a multi country study that has involved patients from 11 study sites in Uganda, Guinea, Niger, Nigeria and Bangladesh which dictate's duration of catheterization for 14 days and more was associated with failure to close the Fistula compared to women catheterized for less than 14 days [32,48].…”

Section: Discussionsupporting

confidence: 61%

“…Since recovery after surgery generally takes two weeks, patient's bladder needs drainage through a catheter traditionally for two weeks [32,46,47]. This is also in agreement with the findings of a multi country study that has involved patients from 11 study sites in Uganda, Guinea, Niger, Nigeria and Bangladesh which dictate's duration of catheterization for 14 days and more was associated with failure to close the Fistula compared to women catheterized for less than 14 days [32,48]. There is no statistically significant deference on multi variable analysis among patients who delivered at home and at health institution.…”

Section: Discussionmentioning

confidence: 99%

“…Further, there is a shortage of reliable data around social, demographic and clinical factors associated with time to recovery from obstetric Fistula surgical repair that will be valuable for managing health care institution through planning, monitoring and evaluation of quality of care as well as use of human and material resources [29][30][31][32][33][34][35].…”

Section: Significance Of the Studymentioning

confidence: 99%

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Predictors of Time to Recovery from a Surgical Repair of Obstetric Fistula at Mekelle Hamlin Fistula Center, Tigray, Ethiopia

Hailu¹

2018

J Preg Child Health

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Background: Ethiopia is one of the high fistula burdened countries in the world with an annual occurrence of 3,500 new and existence of 37,500 untreated obstetric fistula cases. Studies conducted in this area focus on determinants of obstetric fistula before surgical repair and researches addressing the associated factors are limited.Objective: To estimate time to recovery from a surgical repair of obstetric fistula and its associated factors among patients treated at Mekelle Hamlin Fistula Center. Results: The patients were followed for 6657 person days at risk, the median recovery time was 20 days. The overall recovery rate was 2.5 cases per 100 person days. Multivariable Cox proportional hazard model result showed labor duration of two or more days (AHR=0.73, 95% CI=0.53, 0.99) and post-operative bladder catheterization longer than 14 or more days (AHR=0.45, 95% CI=0.32, 0.62) were factors negatively associated with recovery time from obstetric fistula surgery. Methods Conclusion and recommendations:women who experienced labor of two or more days and post-operative bladder drainage for more than two or more weeks took longer time to recover after the repair. Therefore, Decision makers, Health care professionals, Stakeholders and Researchers should give emphasis on activities that reduce delays' in decision making, delays' in giving urgent intervention and delays' in reaching health institutions that contributes in reducing complications of prolonged labor ultimately obstetric fistula.Harmful traditional practices such as early marriage and home delivery are other potential factors for the development of obstetric fistula [8][9][10]. Globally, nine to 84% of obstetric fistula patients gave birth at home and more than 2 million women are currently living with this problem. Additional 50,000 to 100,000 new cases are estimated to occur each year and majority of which are from Africa and Asia [9][10][11][12][13].Incidence rates of obstetric fistula in countries with high maternal mortality is as high as two to three cases per 1000 women [14]. Estimated incidence and prevalence of untreated obstetric fistula in Ethiopia during the year 2010 was 3,500 and 37,500, respectively [9,15]. Introduction BackgroundObstetric fistula is an injury that occurs during prolonged or obstructed labor causing tissue damage to organs inside the pelvis and resulting in incontinence of urine, feces or both. The dead tissues due to prolonged pressure fall away and a hole will be formed between the vagina and bladder called Vesico-vaginal Fistula (VVF) or between the vagina and rectum called Recto Vaginal Fistula (RVF) [1][2][3].Obstetric fistula is the worst child birth related complication that contributes for 2.5% of the Global daily death of mothers associated with child birth related complications [4].The main causes of obstetric fistula in the developed world are radiation therapy and surgery whereas in developing countries, "the three delays" are responsible, the delay in seeking skilled emergency obstetric care, the del...

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Significance Of the Studymentioning

confidence: 99%

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Predictors of Time to Recovery from a Surgical Repair of Obstetric Fistula at Mekelle Hamlin Fistula Center, Tigray, Ethiopia

Hailu¹

2018

J Preg Child Health

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“…Others, (e.g. Goh, 8 Tafesse 9 and Waaldijk 10 ) are more detailed, describing the extent to which varying anatomical structures are affected, as well as factors such as bladder and fistula size. The more detailed systems allow for a precise description of the fistula, with the implicit assumption that as type increases by number or letter combination (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Using data collected as part of a multi-country prospective cohort study, our primary aim was to test the diagnostic performance of five classification systems (Lawson’s, 7 Waaldijk’s, 10 Tafesse’s, 9 Goh’s, 8 and WHO 13 ) to predict fistula closure. These systems are either commonly used in clinical settings (Waaldijk and Goh), or represent a range of detail, from more sparse (Lawson) to more exhaustive (Tafesse and WHO).…”

Section: Introductionmentioning

confidence: 99%

Development and comparison of prognostic scoring systems for surgical closure of genitourinary fistula

Frajzyngier

Larson

et al. 2013

American Journal of Obstetrics and Gynecology

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Objective To test the diagnostic performance of five existing classification systems (developed by Lawson, Tafesse, Goh, the World Health Organization (WHO) and Waaldijk), and a prognostic scoring system derived empirically from our data, to predict fistula closure three months following surgery. Study Design Women with genitourinary fistula (n=1274) presenting for surgical repair services at 11 health facilities in sub-Saharan Africa and Asia were enrolled in a prospective cohort study. Using one-half the sample we created multivariate generalized estimating equation models to obtain weighted prognostic scores for components of each existing classification system, and the empirically-derived scoring system. With the second half, we developed Receiver Operating Characteristic curves using the prognostic scores and calculated areas under the curves (AUCs) and 95% confidence intervals (CI) for each system. Results Among existing systems, the scoring systems representing the WHO, Goh and Tafesse classifications had the highest predictive accuracy: AUC 0.63 (95%CI: 0.57-0.68), AUC 0.62 (95%CI: 0.57-0.68) and AUC 0.60 (95%CI: 0.55-0.65), respectively. The empirically-derived prognostic score achieved similar predictive accuracy (AUC 0.62, 95%CI: 0.56-0.67); it included significant predictors of closure found in the other classification systems, but contained fewer, non-overlapping components. Differences in AUCs were not statistically significant. Conclusions The prognostic values of existing urinary fistula classification systems and the empirically-derived score were poor to fair. Further evaluation of the validity and reliability of existing classification systems to predict fistula closure is warranted, with consideration given to a prognostic score that is evidence-based, simple and easy to use.

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Panzi score as a parsimonious indicator of urogenital fistula severity derived from Goh and Waaldijk classifications

Mukwege

Peters

Amisi

et al. 2018

Intl J Gynecology & Obste

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A New Classification of Female Genital Fistula

Cited by 11 publications

References 0 publications

Predictors of Time to Recovery from a Surgical Repair of Obstetric Fistula at Mekelle Hamlin Fistula Center, Tigray, Ethiopia

Predictors of Time to Recovery from a Surgical Repair of Obstetric Fistula at Mekelle Hamlin Fistula Center, Tigray, Ethiopia

Development and comparison of prognostic scoring systems for surgical closure of genitourinary fistula

Panzi score as a parsimonious indicator of urogenital fistula severity derived from Goh and Waaldijk classifications

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