Depression among women with obstetric fistula, and pelvic organ prolapse in northwest Ethiopia

Abstract

BackgroundThe prevalence of depression is not well studied among women with pelvic floor disorders. Hence, this study aimed to determine the prevalence of depression and its associated factors among women with pelvic floor disorders.MethodsA cross-sectional study was conducted among 306 women with one or more of the advanced pelvic floor disorders who attended at the gynaecologic outpatient clinic of Gondar university referral hospital in the six months data collection period. Women who complained of urinary or faecal incontinence or protruding mass per vagina were assessed and staged accordingly. Eligible women i.e. those with advanced pelvic organ prolapse or obstetric fistula were included consecutively. A structured questionnaire was used to obtain socio-demographic data and medical histories for all consenting women. Interviews were done by a female midwife nurse. Depression measures were obtained using the Beck’s Depression Inventory (BDI) tool administered by the midwife nurse after intensive training. Data were entered into a computer using Epi Info version 3. 5.3, and then exported to SPSS version 20 for analysis. Multiple logistic regressions were fitted and Odds ratios with 95% confidence intervals were calculated to identify associated factors.ResultsOf the 306 women interviewed, 269 had advanced pelvic organ prolapse (stages 3 and 4), 37 had obstetric fistula. All four women (100%) with both faecal and urinary incontinence, 97.0% those with urinary incontinence due to obstetric fistula and 67.7% of those with advanced pelvic organ prolapse (stages 3 and 4) had symptoms of depression. Depression was significantly associated with age 50 years or older (P < 0.01), marital status (P < 0.05), history of divorce (p < 0.01), self perception of severe problem (P < 0.05), and having stage 3 pelvic organ prolapse (P < 0.01).ConclusionWomen with advanced pelvic organ prolapse, and obstetric fistula had high prevalence of depressive symptoms. A holistic management approach, including mental health care is recommended for women having such severe forms of pelvic floor disorders.

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study

“…We were surprised to find the low prevalence of depressive symptoms in our study cohort after fistula repair. In other contexts of fistula patients, pre‐operative rates of depression have ranged from 59 to 97% . Another study also found that women with residual incontinence have higher rates of depression (100%) after repair compared with those who are not leaking (29%) .…”

“…In other contexts of fistula patients, pre-operative rates of depression have ranged from 59 to 97%. 30,31 Another study also found that women with residual incontinence have higher rates of depression (100%) after repair compared with those who are not leaking (29%). 32 However, in that study, the follow-up time after repair was only 2 weeks.…”

Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, North West Ethiopia: a case&ndash;control study

“…Similarly, studies in Nigeria10 and Nepal11 showed that different forms of POP have been affecting women’s health and quality of life alarmingly 12. Women with POP have been suffering from significant social problems such as sexual relationships problems, functional impairment, depression, and poor quality of life 13–17. In Ethiopia, gynecological problems are important health problems affecting maternal health outcomes and women’s productivity 18.…”

Physical etiology of sexual dysfunction in obstetric fistula patients: A prospective study

“…In previous studies, the majority of women with fistula have described symptoms of mood disorders, including suicidal ideations . Yeakey found that much of this was a result of being unable “to fulfil social expectations of them as women, wives and mothers”.…”