Experiences with fistula repair surgery among women and families in Malawi

Yeakey, Marissa Pine; Chipeta, Effie; Rijken, Y.; Taulo, Frank; Tsui, Amy O.

doi:10.1080/17441692.2010.491833

Cited by 38 publications

(69 citation statements)

References 13 publications

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“…Studies by Women's Dignity Project & EngenderHealth (), Yeakey et al . () and EngenderHealth () described women's experiences of the difficulty in accessing treatment. Alio et al .…”

Section: Resultsmentioning

confidence: 99%

An integrative review on women living with obstetric fistula and after treatment experiences

Degge

Hayter

Laurenson

2017

Journal of Clinical Nursing

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“…Studies by Women's Dignity Project & EngenderHealth (), Yeakey et al . () and EngenderHealth () described women's experiences of the difficulty in accessing treatment. Alio et al .…”

Section: Resultsmentioning

confidence: 99%

An integrative review on women living with obstetric fistula and after treatment experiences

Degge

Hayter

Laurenson

2017

Journal of Clinical Nursing

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“…The age observed in our series is close to that found by Yeakey and al. [12] in Malawi, Tegbeu [13] in Cameroon (37 years old) and Arshad [14] in Tunisia (35.5 years old). However, this age varies between 25 and 30 years for most authors around the world [4] [6] [9] [15].…”

Section: Discussionmentioning

confidence: 99%

Determinants of Outcomes and Prognosis Score in Obstetric Vesico-Vaginal Fistula Repair

Mubikayi¹,

Matson²,

Lokomba³

et al. 2017

OJOG

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An estimated 2 million women living in countries with limited resources currently have vesico-vaginal, recto-vaginal, or mixed types of fistulae because of the necrosis that occurs with obstructed labor. We evaluated factors readily assessed by the examining practitioner in a consecutive case series of surgical repairs of obstetrical fistulae, for the ability of those factors to stand as a prognostic guide, in a clinical score. Objectives: To identify the predictors of surgical repair outcomes and establish a Score combining these different determinants to facilitate the care of obstetric fistula. Methods: We conducted a multicentric prospective study between 2011 and 2014 in Democratic Republic of the Congo (DRC). Outcomes: We measured 3 months post-surgery in a series of 483 patients with obstetrical fistula repaired by the same surgeon included closure and failure appreciated by dye test. Multivariable generalized estimating equation models were used to generate adjusted odd ratios (OR) and 95% confidence intervals (CIs). The scores ranging from 3 to 14 were established from the outcomes determinants identified. Results: In total, 483 women were enrolled, and 390 cases were at their first surgery and were included in the obstetric fistula (OF) prognosis score and classification. Their mean age was 35 years at the time of the surgery and 25 years at the onset of OF. In 28.6%, the fistula patient was primigravida. Mean duration between onset of the fistula and surgical treatment was 8 years. In 24%, the fistula patients lived separated from their partners. Overall closure rate of the fistulas was 85.7%. Severe vaginal fibrosis (p < 0.01), big fistula size (<0.01), small distance from fistula to external urethral meatus (<0.01) and prior surgery (p < 0.48) predicted failed fistula closure. A clinical score ranging from 3 to 14 points is a prognostic score with a range of 1 to 4 for the distance between the fistula and the external meatus and the size, and a scale of 1 to 6 for fibrosis. 768Conclusions: This study demonstrated that the marked vaginal scarring; large fistula size and distance to urethral meatus are predictors for unsuccessful fistula repair. Due to the lack of a standard classification that is never unanimous among the different surgeons, this prognostic score allows the combination of the different determinants assessing the chances of success and can help the practitioners to orient the patients towards the determined skill scale to take care of the patients.

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“…In qualitative studies, fistula patients recount experiences of improved quality of life and overall levels of happiness after fistula repair [14– 16]. In a study in Ethiopia, fistula patients reported a decrease in psychological distress from admission to 2 weeks post-surgery, prior to discharge [17].…”

Section: Introductionmentioning

confidence: 99%

Psychological Symptoms and Social Functioning Following Repair of Obstetric Fistula in a Low-Income Setting

Wilson

Sikkema

Watt

et al. 2016

Matern Child Health J

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Objectives Obstetric fistula is a maternal injury that causes uncontrollable leaking of urine or stool, and most women who develop it live in poverty in low-income countries. Obstetric fistula is associated with high rates of stigma and psychological morbidity, but there is uncertainty about the impact of surgical treatment on psychological outcomes. The objective of this exploratory study was to examine changes in psychological symptoms following surgical fistula repair, discharge and reintegration home. Methods Women admitted for surgical repair of obstetric fistula were recruited from a Tanzanian hospital serving a rural catchment area. Psychological symptoms and social functioning were assessed prior to surgery. Approximately 3 months after discharge, a data collector visited the patients' homes to repeat psychosocial measures and assess self-reported incontinence. Baseline to follow-up differences were measured with paired t tests controlling for multiple comparisons. Associations between psychological outcomes and leaking were assessed with t tests and Pearson correlations. Results Participants (N = 28) had been living with fistula for an average of 11 years. Baseline psychological distress was high, and decreased significantly at follow-up. Participants who self-reported continued incontinence at follow-up endorsed significantly higher PTSD and depression symptoms than those who reported being cured, and severity of leaking was associated with psychological distress. Conclusions Fistula patients experience improvements in mental health at 3 months after discharge, but these improvements are curtailed when women experience residual leaking. Given the rate of stress incontinence following surgery, it is important to prepare fistula patients for the possibility of incomplete cure and help them develop appropriate coping strategies.

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Experiences with fistula repair surgery among women and families in Malawi

Cited by 38 publications

References 13 publications

An integrative review on women living with obstetric fistula and after treatment experiences

An integrative review on women living with obstetric fistula and after treatment experiences

Determinants of Outcomes and Prognosis Score in Obstetric Vesico-Vaginal Fistula Repair

Psychological Symptoms and Social Functioning Following Repair of Obstetric Fistula in a Low-Income Setting

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