A review of surgical procedures to repair obstetric fistula

Pope, Rachel; Beddow, Meghan

doi:10.1002/ijgo.13035

Cited by 26 publications

(16 citation statements)

References 43 publications

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“…Among these techniques are the Singapore fasciocutaneous flap and the gracilis muscle flap. [6][7][8][9][10] The Singapore fasciocutaneous flap, also known as the pudendal-thigh flap, is a relatively new technique that is introduced in obstetric fistula repair. 8 The flap offers a robust blood supply from the internal pudendal artery and the extensiveness of the flap makes it possible to cover the complete vaginal cavity when applied bilaterally.…”

Section: Introductionmentioning

confidence: 99%

“…Multiple techniques have been described to introduce new viable tissue into the vagina to achieve tension‐free closure without compromising the bladder and vagina and to optimize vascularization around the fistula repair. Among these techniques are the Singapore fasciocutaneous flap and the gracilis muscle flap 6–10 . The Singapore fasciocutaneous flap, also known as the pudendal‐thigh flap, is a relatively new technique that is introduced in obstetric fistula repair 8 .…”

Section: Introductionmentioning

confidence: 99%

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Follow‐up of obstetric fistula repair using Singapore fasciocutaneous flap and/or gracilis muscle flap

Maljaars

Nundwe²,

Roovers

et al. 2021

Neurourology and Urodynamics

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Aims: To report on the follow-up of obstetric fistula repair using vascularized surgical flaps, namely the Singapore fasciocutaneous flap, the gracilis muscle flap, or a combination of both.Methods: This cross-sectional study reports on the follow-up of 60 patients after fistula repair with a vascularized surgical flap at the Fistula Care Center in Lilongwe, Malawi. The primary outcome was fistula closure based on patients' self-reported continence grade. Secondary outcomes were urinary incontinence based on a 1-h pad-weight test, quality of life based on the Incontinence Quality of Life (I-QOL) questionnaire, surgical complications, and the indication for additional surgery after repair.Results: Successful closure was achieved in 62% of cases and full continence was achieved in 12% of cases. Incontinence based on a 1-h pad weight test improved between surgery and follow-up. QOL scores based on the I-QOL were low but patients indicated moderate to great improvement in quality of life. Twenty-two (37%) patients experienced surgical complication, mostly minor wound breakdowns. No major complications were reported. Six (10%) patients were indicated for additional surgery during follow-up. Conclusion:The relative safety of the surgical procedures is shown in the findings of this study, including no reports on major complications during follow-up. Vascularized flaps should be considered in complex fistula cases, especially in repeat cases and before considering urinary diversion as a last resort.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Follow‐up of obstetric fistula repair using Singapore fasciocutaneous flap and/or gracilis muscle flap

Maljaars

Nundwe²,

Roovers

et al. 2021

Neurourology and Urodynamics

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“…As genital fistula repair lacks evidence-based guidance, management must be tailored to the underlying pathology and the surgeon's experience [1]. The aim of this retrospective study was to evaluate the causes and management of OGF in women treated at a pelvic floor centre in a developed country between January 2006 and June 2020.…”

Section: Introductionmentioning

confidence: 99%

Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany

et al. 2021

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Background Obstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre. Methods Women who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified, and their records were reviewed retrospectively. Results Eleven out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort, genitourinary fistulas were more common in multiparous women (9/11), and rectovaginal fistulas were more common in primiparous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina, and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65% of cases. Women who suffered from rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended fistula repair in the context of a subsequent delivery. For the first time, pregnancy-related changes in the vaginal wall were used to optimize the success rate of fistula closure. Conclusions In developed countries, birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, management must be tailored to the underlying pathology and the surgeon’s experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Although vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient, and a vesicovaginal fistula should be ruled out. Trial registration Retrospectively registered, DRKS 00022543, 28.07.2020.

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“…Moreover, Obstetric stula is devastating lifelong morbidity if left untreated, with severe medical, social, psychological and economic consequences (4),(6), (7), (8). The underlying factors contributing to Obstetrics stula including no skilled birth attendants(9),(10), poor health -seeking behavior, poor referral system and transportation (11), (12) network (11), (13), age and physical maturity (12), (14), (15),(16), iatrogenic surgical damage(9), Educational status((10), (17), (18), sexual violence(16), poverty (11), (13), lack of awareness(5),( 12),( 15), (19) and not spacing between child births(9). Despite these contributing factors, the main reason why women preventing from Fistula care was due to lack of awareness on obstetric stula prevention and treatment takes a lion share(6)and lack of awareness is a leading reason to seeking treatment (7).…”

Section: Introductionmentioning

confidence: 99%

Awareness of Obstetric Fistula and Associated Factors Among Women in Reproductive Age Group Attending Public Hospitals, Ilubabor Zone, Oromia Regional State, South West Ethiopia, 2021

Rundasa¹,

Wolde²,

Bayisa³

et al. 2021

Preprint

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Background: Obstetric fistula occurs in all developing countries but it is confined to the “fistula belt” across the northern half of Sub-Saharan Africa from Mauritania to Eritrea and in the developing countries of the Middle East and Asia. Ending obstetric fistula is critical to achieving the Sustainable Development by 2030. So creating awareness on obstetrics fistula among women in reproductive age group have crucial role in reducing morbidity, mortality and social stigma.Objective: To assess awareness on obstetric fistula and its associated factors among reproductive age women attending governmental hospitals in Ilubabor zone, Oromia region, Ethiopia, 2021.Methods: Institutional based cross-sectional study design was conducted. The sample size was estimated by using a single population proportion formula. The collected data was coded and entered to Epi data version 3.1 then exported to SPSS version 24 for descriptive and inferential analysis. Adjusted odds ratio (AOR) along with 95% confidence level was estimated to assess the strength of the association and a p value <0.05 was considered to declare the statistical significance in the multivariable analysis in this study.Result: In this study a total of 400 clients were participated in the study. The mean ages of participants were 30.26 (SD±8.525) years old. Education of women’s who cannot read and write are 85% less likely to have good awareness than women who are above secondary level of education (AOR=0.162:95% CI (0.081-0.364)). While Women’s who have primary education level are 83% less likely to have good awareness than women who are above secondary level of education (AOR=0.170:95% CI (0.085-0.446)).In addition, my study shows women’s who haven’t heard about obstetric complication are 54% less likely to have awareness on obstetric fistula than those who heard about obstetric complication (AOR=0.458:95% CI (0.368-0.643). Conclusion: This study identifies that, educational level of women, history of pregnancy, distance to the nearby health institution and awareness on obstetrics complications were the factors associated with awareness of reproductive age women on obstetrics fistula. Hence, increasing awareness on obstetric fistula plays a key role to avert this problem.

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A review of surgical procedures to repair obstetric fistula

Cited by 26 publications

References 43 publications

Follow‐up of obstetric fistula repair using Singapore fasciocutaneous flap and/or gracilis muscle flap

Follow‐up of obstetric fistula repair using Singapore fasciocutaneous flap and/or gracilis muscle flap

Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany

Awareness of Obstetric Fistula and Associated Factors Among Women in Reproductive Age Group Attending Public Hospitals, Ilubabor Zone, Oromia Regional State, South West Ethiopia, 2021

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