Fistula Campaigns—Are They of Any Benefit?

Çam, Çetin; Karateke, Ateş; Özdemir, Arman; Gunes, Candemir; Çelik, Cem; Guney, Buhara; Vatansever, Doğan

doi:10.1016/s1028-4559(10)60063-0

Cited by 14 publications

(9 citation statements)

References 20 publications

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“…Many authors have remarked that the first surgical repair is the most likely to be successful [ 20 – 23 ]. Our results provide further evidence that clinical outcomes are better when obstetric fistula surgery is performed in specialist centers by expert surgeons supported by trained fistula nurses [ 15 , 24 , 29 , 30 ].…”

Section: Discussionsupporting

confidence: 53%

Obstetric fistula in Niger: 6-month postoperative follow-up of 384 patients from the Danja Fistula Center

et al. 2017

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Introduction and hypothesisThe impoverished West African country of Niger has high rates of obstetric fistula. We report a 6-month postoperative follow-up of 384 patients from the Danja Fistula Center and assess factors associated with operative success or failure.MethodsThe medical records of 384 women who had completed a 6-month follow-up after fistula surgery were reviewed. Cases were categorized as “easy,” “of intermediate complexity,” or “difficult” based on a preoperative points system. Data were analyzed using simple chi-squared statistics and logistic regression.ResultsThe patients were predominantly of Hausa ethnicity (73%), married young (average 15.9 years), had teenage first pregnancies (average first delivery 16.9 years), and experienced prolonged labor (average 2.3 days) with poor outcomes (89% stillbirth rate). The average parity was four. Patients commonly developed their fistula during their first delivery (43.5%), but over half sustained a fistula during a subsequent delivery (56.5%). Prior fistula surgery elsewhere (average 1.75 operations) was common. The overall surgical success (“closed and dry”) was 54%. When the 134 primary operations were analyzed separately, the overall success rate was 80%. Increasing success was seen with decreasing surgical difficulty: 92% success for “easy” cases, 68% for “intermediate” cases, and 57% success for “difficult” cases. Success decreased with increasing numbers of previous attempts at surgical repair.ConclusionsThese data provide further evidence that clinical outcomes are better when primary fistula repair is performed by expert surgeons in specialist centers with the support of trained fistula nurses.

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Section: Discussionsupporting

confidence: 53%

Obstetric fistula in Niger: 6-month postoperative follow-up of 384 patients from the Danja Fistula Center

et al. 2017

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“…Public health Arts and Social Sciences Journal, Vol. 2012: ASSJ-41 campaigns are being done in some countries and are having tremendous effects for instance in Niger, 62 women came together 11 months following public campaigns, with 82% of them diagnosed as suffering from OF and likewise more than half of these patients (66%) had a history of previous attempts for repair [25].…”

Section: Public Health Interventions To Mitigate the Impact Of Obstetmentioning

confidence: 99%

Obstetric Fistula: A Hidden Public Health Problem In Sub-Saharan Africa

Kalembo¹,

M.Zgambo²

2012

Arts and Social Sciences Journal

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Obstetric fistula (OF) continues to devastate the lives of women in sub-Saharan Africa. Many women with the condition are suffering in silence. They are unaware of the available treatment options or unaware of where to get treatment. Yet, the condition is treatable and preventable. Recently, many countries and nongovernmental organizations (NGOs) in the region embarked on interventions to address the impact of the condition, however, much emphasis is put to identifying and treating the existing cases with less emphasis put to public health interventions that can help to prevent and eventually eradicate the condition in sub-Saharan Africa. Therefore, the purpose of this review is to explore the impact of obstetric fistula in the region and to propose effective public health interventions that can help to prevent the condition with a long-term goal of eradicating the condition.

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“…9 This is particularly true in the context of 'fistula camps,' where surgeries are performed over intensive, short periods with little long-term postoperative care. 10 To address this gap, we conducted a follow-up study of VVF repair performed at least 12 months previously and investigated the prevalence of long-term residual incontinence and its associated risk factors. Our secondary objectives were to measure incontinence-associated quality of life scores and to screen for depression in women who had previously undergone VVF repair.…”

Section: Introductionmentioning

confidence: 99%

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

Kopp

Tang

Bengtson

et al. 2018

BJOG

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Objective We evaluated residual incontinence, depression, and quality of life among Malawian women who had undergone vesicovaginal fistula (VVF) repair 12 or more months previously. Design Prospective cohort study. Setting Fistula Care Centre in Lilongwe, Malawi. Population Women who had undergone VVF repair in Lilongwe, Malawi at least 12 months prior to enrolment. Methods Self‐report of urinary leakage was used to evaluate for residual urinary incontinence; depression was evaluated with the Patient Health Questionnaire‐9; quality of life was evaluated with the King's Health Questionnaire. Main outcome measures Prevalence and predictors of residual incontinence, quality of life scores, and prevalence of depression and suicidal ideation. Results Fifty‐six women (19.3%) reported residual urinary incontinence. In multivariable analyses, predictors of residual urinary incontinence included: pre‐operative Goh type 3 [adjusted risk ratio (aRR) 2.82; 95% confidence interval (CI) 1.61–5.27) or Goh type 4 1.08–2.78), positive postoperative cough stress test (aRR = 2.42; 95% CI 1.24–4.71) and the positive 1‐hour postoperative pad test (aRR = 2.20; 95% CI 1.08–4.48). Women with Goh types 3 and 4 VVF reported lower quality of life scores. Depressive symptoms were reported in 3.5% of women; all reported residual urinary incontinence. Conclusions While the majority of women reported improved outcomes in the years following surgical VVF repair, those with residual urinary incontinence had a poorer quality of life. Services are needed to identify and treat this at‐risk group. Tweetable abstract Nearly one in five women reported residual urinary incontinence at follow up, 12 or months after vesicovaginal fistula repair.

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Fistula Campaigns—Are They of Any Benefit?

Abstract: It is extremely difficult to meet the needs of this global problem with short term programs and volunteers. Directing these efforts to specialist fistula centers and creating reliable scientific evidence should be the main goal.

Cited by 14 publications

References 20 publications

Obstetric fistula in Niger: 6-month postoperative follow-up of 384 patients from the Danja Fistula Center

Obstetric fistula in Niger: 6-month postoperative follow-up of 384 patients from the Danja Fistula Center

Obstetric Fistula: A Hidden Public Health Problem In Sub-Saharan Africa

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

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