Predictors of Recurrence and Successful Treatment Following Obstetric Fistula Surgery

Loposso, Matthieu Nkumu; Hakim, Lukman; Ndundu, Jean Muzembo; Lufuma, Simon; Punga, Augustin Maole; Ridder, Dirk De

doi:10.1016/j.urology.2016.03.079

Cited by 21 publications

(10 citation statements)

References 17 publications

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“…The magnitude of obstetric fistula repair failure in this study was consistent with that of studies conducted in Benin (26.8%) [ 31 ] and the Democratic Republic of Congo (28.3%) [ 32 ]. The findings' consistency could be attributable to the patients' fistula characteristics being similar and comparable data duration being included in the study.…”

Section: Discussionsupporting

confidence: 89%

Obstetric fistula repair failure and its associated factors among women underwent repair in Yirgalem Hamlin fistula center, Sidama Regional State, Southern Ethiopia, 2021: a retrospective cross sectional study

Tadesse¹,

Ejigu

Edosa³

et al. 2022

BMC Women's Health

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Background Obstetric fistula repair failure is a combination of unsuccessful fistula closure and/or incontinence following a successful closure. It causes a burden on both the patients and the fistula centers. The aim of this study was to assess the magnitude and associated factors of obstetric fistula repair failure among women who underwent fistula repair at Yirgalem Hamlin fistula center in Southern Ethiopia. Methods A facility-based retrospective cross-sectional study was conducted among women who underwent fistula repair at Yirgalem Hamlin fistula center, Southern Ethiopia, during the period from January 2016 to December 2020. All 562 women who underwent fistula repair in the last 5 years were included in the study. The data were collected using a pre-tested checklist from September 22 to October 22, 2021. The data were then imported into EPI info-data version 3.1, exported to SPSS version 25, and analyzed. Descriptive and logistic regression analyses were performed, and the significant statistical test was assessed at a 95% confidence interval. Variables with a p value of < 0.05 in multivariable logistic regression were regarded to have a statistically significant relationship. Results The magnitude of obstetric fistula repair failure in this study was 28.8%. Obstetric fistula repair failure was found to be associated with labor duration > 48 h (AOR = 2.037; 95% CI 1.268, 3.272), Goh Type 4 fistulas (AOR = 3.939; 95% CI 1.623, 9.560), fistula size > 3 cm (AOR = 6.627; 95% CI 3.802, 11.554), completely destructed urethra (AOR = 3.192; 95% CI 1.234, 8.256), and bladder catheterization > 14 days (AOR = 2.944; 95% CI 1.380, 6.281). Conclusions The magnitude of obstetric fistula repair failure was significantly higher than the World Health Organization standard. Obstetric fistula repair failure had a positive association with a longer duration of labor, Goh Type 4 fistulas, large fistula size, total urethral injury, and a longer period of bladder catheterization. Therefore, the concerned bodies need to implement interventions on factors affecting obstetric fistula repair failure to reduce or prevent the failure of obstetric fistula repair.

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Section: Discussionsupporting

confidence: 89%

Obstetric fistula repair failure and its associated factors among women underwent repair in Yirgalem Hamlin fistula center, Sidama Regional State, Southern Ethiopia, 2021: a retrospective cross sectional study

Tadesse¹,

Ejigu

Edosa³

et al. 2022

BMC Women's Health

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“…The average age in both study groups was 26±8.02 years, similar to reports from Africa and Asia with the mean age at treatment around 25-29. [22][23][24] Proportion of unmarried women (65.2%) was higher than that of 40 to 50 % reported by others. 25,26 The majority of patients in both study populations had primary level of education (54.3%).…”

Section: Discussioncontrasting

confidence: 54%

“…Many studies report fibrotic status of genitourinary fistula up to 20.5% in the DRC, 64.9% in Uganda and 70.4% in Nigeria. 19,22,40 This condition affects the prognosis of fistula surgery as limiting factor for tissue dissection. This sclerotic nature can be the consequence of previous surgical attempts that increase the risk of vaginal fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcome of genito-urinary obstetric fistulas (GUOF) with or without bladder neck involvement: an experience from the University Teaching Hospital, Yaoundé, Cameroon

Marie¹,

Ekono²,

Ndoua³

et al. 2019

OGIJ

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This suggestion only takes into account the past surgical history, but not anatomical features of the fistula (location, size, fibrosis). 16-18 Some studies reported prognostic value of urethral location and the fistula increased failure risk in case their involvement. 19,20 Success of 57% was reported for cervico-urethral location and 79% for bladder body involvement. 21 Little data exists on the prognosis of obstetric fistula with urethral involvement in Cameroon. Objective: Analyze post-surgical outcome of genitourinary obstetric fistula with or without urethral involvement. Methodology This was a retrospective cohort study in the University Teaching Hospital, Yaounde on GUOF patients operated from 03 March 2009 to 3 March 2015 (six years). We considered obstetric fistula with urethral involvement "subject group" and obstetric fistula without urethral involvement "control group". Patient's files were reviewed, we excluded non-obstetric, genitourinary digestive and vesico-uterine cases. After an oral consent, we collected data through registers,

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“…Según la literatura la etiología obstétrica aumenta 3 veces el riesgo. (12,34) Debido a la dificultad técnica que se presenta por el exceso de tejido adiposo en pacientes con obesidad, se esperaba que las pacientes con mayor IMC presentaran recurrencia, contrario a lo esperado, nuestro caso presentó un IMC de 26.04 kg/m2, que lo clasifica en sobrepeso, pero no en obesidad.…”

Section: Discussionunclassified

Our experience with laparoscopic repair of the vesicovaginal fistula

et al. 2020

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Antecedentes: La fístula vesicovaginal (FVV) tiene una incidencia de 30 000 a 130 000 casos por año, generalmente asociados con histerectomía abdominal, cáncer y radiación pélvica. Para el diagnóstico es necesario realizar vaginoscopia, cistoscopia y cistografía. La mejor oportunidad para obtener resultados favorables es en el primer intento quirúrgico. Objetivo: Reportar los resultados obtenidos en el abordaje laparoscópico de fístula vesicovaginal en nuestro centro hospitalario. Materiales y métodos: Estudio descriptivo, ambispectivo en pacientes con FVV sometidos a reparación laparoscópica desde marzo de 2016 hasta noviembre de 2019. Resultados: Se incluyeron 15 pacientes sometidas a reparación de FVV por laparoscopia, con una edad media de 46.2 años e IMC promedio de 30.1 kg/m2. Los comórbidos asociados más frecuentes se encontraron HAS seguido de Ca de endometrio, con el antecedente quirúrgico ginecológico en el 100% de las pacientes. Del total, 1 paciente presentó recurrencia;1 paciente presenta complicación Clavien-Dindo III (6.67%). Discusión: En nuestro estudio, el 93.33% de los casos fueron causados por una histerectomía. Se informó que el paciente que presentó recurrencia de FVV presentaba tejido fibrótico leve, ubicación supratrigonal y tamaño de fístula de 3 mm, contrario a lo informado en la literatura. Conclusión: La reparación videoasistida por laparoscopía de la fistula vesicovaginal en nuestro hospital se reportó como un procedimiento seguro, con una incidencia de éxito del 93.3% (14 pacientes) en la primera intervención. Se encontró, además que la presencia de un proceso fibrótico moderado pudiera condicionar mayor dificultad técnica, aunado al sangrado transquirúrgico >250 cc. y estancia hospitalaria >3 días.

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Predictors of Recurrence and Successful Treatment Following Obstetric Fistula Surgery

Cited by 21 publications

References 17 publications

Obstetric fistula repair failure and its associated factors among women underwent repair in Yirgalem Hamlin fistula center, Sidama Regional State, Southern Ethiopia, 2021: a retrospective cross sectional study

Obstetric fistula repair failure and its associated factors among women underwent repair in Yirgalem Hamlin fistula center, Sidama Regional State, Southern Ethiopia, 2021: a retrospective cross sectional study

Surgical outcome of genito-urinary obstetric fistulas (GUOF) with or without bladder neck involvement: an experience from the University Teaching Hospital, Yaoundé, Cameroon

Our experience with laparoscopic repair of the vesicovaginal fistula

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