Profile and outcome of patients with recurrent urogenital fistula in a fistula centre in Nigeria

Okunola, Temitope Omoladun; Yakubu, Emmanuel; Daniyan, Babafemi; Ekwedigwe, Kenneth Chinedu; Eliboh, M. O.; Sunday-Adeoye, Ileogben

doi:10.1007/s00192-018-3738-8

Cited by 6 publications

(5 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We were able to demonstrate one factor with predictive value for successful surgical outcome. In another study on patients with recurrent fistulas, significant associations were demonstrated between the number of previous repairs, age, fistula classification, duration of the fistula, surgeon's experience, and the place where the repair was attempted [18]. However, no multivariate analysis was performed to control for confounders and probably most significance would be lost if a multivariate analysis were used, as shown in our study.…”

Section: Discussionmentioning

confidence: 50%

See 1 more Smart Citation

Predictors of outcomes in patients with repeat surgery for obstetric fistula: a retrospective review

et al. 2023

View full text Add to dashboard Cite

Introduction and hypothesis Predictors of surgical outcomes in patients with an obstetric fistula who have been operated before should be identified in order to guide surgical strategy and optimize counseling of the patient. Methods This retrospective study is aimed at identifying predictors of outcomes for repeat surgery in 346 patients who had been operated on before for an obstetrics fistula at the Fistula Care Center (FCC) in Lilongwe, Malawi. Repeat cases were only undertaken by advanced and expert surgeons. The primary outcome was successful anatomical closure, based on a negative postoperative dye test. The secondary outcomes involved urinary continence, based on a patient-reported questionnaire and an objective 1-h pad weight test. Logistic regression models were used to test the predictors for statistical significance. Results Successful fistula closure was achieved in 288 (83%) patients and continence was achieved in 185 (64%) patients after the first repeat attempt at the FCC. Lack of urethral involvement (Goh classification: proximity to the urethra) was shown to be a good predictor of the outcomes: fistula closure and subjective and objective continence. Conclusions Absence of urethral involvement is an independent predictor for successful outcomes in repeat surgery for obstetric fistulas. Even in the hands of an expert surgeon, the risk of another failure in achieving anatomical closure or subjective or objective continence is between 4 and 5 times higher than when the urethra is not involved.

show abstract

Section: Discussionmentioning

confidence: 50%

“…The median surgery time was 1:00 [0:40-1:25] h with an estimated blood loss of 50.0 [20-100] ml. The median duration of postoperative catheterization was 14 [14][15][16][17][18][19][20] days.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Predictors of outcomes in patients with repeat surgery for obstetric fistula: a retrospective review

et al. 2023

View full text Add to dashboard Cite

show abstract

“…We also examined the association between fistula classification and successful repair outcome, despite the included studies lacking consistency in classification methods. Out of the seven studies included for the examination of the effect of classification on successful repair outcome, three studies used the Goh classification [ 21 , 40 , 44 ] method and four studies used the Waaldijk classification method [ 51 , 52 , 69 , 76 ]. We analyzed the findings of reports in both classifications after categorizing them into Grade II and above, and Grade I.…”

Section: Discussionmentioning

confidence: 99%

Proportions and determinants of successful surgical repair of obstetric fistula in low- and middle-income countries: A systematic review and meta-analysis

Zeleke,

Welsh,

Abeje

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Background Obstetric fistula is a serious and debilitating problem resulting from tissue necrosis on the reproductive and urinary and/or lower gastrointestinal tract organs due to prolonged labor. Primary studies of the treatment of obstetric fistulae report significantly variable treatment outcomes following surgical repair. However, no systematic review and meta-analysis has yet estimated the pooled proportion and identified the determinants of successful obstetric fistula surgical repair. Objective To estimate the proportion and identify the determinants of successful surgical repair of obstetric fistulae in low- and middle-income countries. Methods The protocol was developed and registered at the International Prospective Register of Systematic Reviews (ID CRD42022323630). Searches of PubMed, Embase, CINAHL, Scopus databases, and gray literature sources were performed. All the accessed studies were selected with Covidence, and the quality of the studies was examined. Finally, the data were extracted using Excel and analyzed with R software. Results This review included 79 studies out of 9337 following the screening process. The analysis reveals that 77.85% (95%CI: 75.14%; 80.56%) of surgical repairs in low and middle-income countries are successful. Women who attain primary education and above, are married, and have alive neonatal outcomes are more likely to have successful repair outcomes. In contrast, women with female genital mutilation, primiparity, a large fistula size, a fistula classification of II and above, urethral damage, vaginal scarring, a circumferential defect, multiple fistulae, prior repair and postoperative complications are less likely to have successful repair outcomes. Conclusion The proportion of successful surgical repairs of obstetric fistula in low and middle-income countries remains suboptimal. Hence, stakeholders and policymakers must design and implement policies promoting women’s education. In addition, fistula care providers need to reach and manage obstetric fistula cases early before complications, like vaginal fibrosis, occur.

show abstract

“…56.2%, 50%, and 0%, respectively. 9 Different initiatives such as the United Nations Population Fund (UNFPA), Maternal Health Task Force (MHTF), countdown, Global Strategy for Women's health, and others have devoted efforts to reducing preventable maternal mortality. 10,11 Despite such efforts, obstetric fistula still compromises the well-being of affected women in all dimensions of their health.…”

Section: Introductionmentioning

confidence: 99%

The Predictors of Intent to Prevent Obstetric Fistula Recurrence Among Women with Fistula in Ethiopia: A Facility-Based Cross-Sectional Study

Hurissa¹,

Koricha²,

Dadi³

2022

IJWH

View full text Add to dashboard Cite

Background Obstetric fistula recurrence predisposes to a decreasing success rate of fistula repair and accounts for the continued incidence of obstetric fistulas in low-income countries. Evidence has revealed that there are women’s intent gaps in the prevention of obstetric fistula recurrence. Assessments of predictors of intent to prevent obstetric fistula recurrence among women with fistula are scarce. Objective This study assessed the intent to prevent obstetric fistula recurrence and its predictive factors among women with obstetric fistula in Ethiopia. Methods Facility-based cross-sectional study was conducted from April 01, 2019, to August 01, 2019, with consecutively selected 478 women with fistulas in five fistula treatment centers in Addis Ababa and Oromia regions. Data were collected using an interviewer-administered structured questionnaire and analyzed using SPSS 23 software. Simple and multiple linear regression models were fitted for data analysis. Results Mean score of intent to prevent obstetric fistula recurrence among women with obstetric fistula was 27.72 ± 5.06. Living in a rural setting (β =−2.27; 95% CI: −3.62, −0.93), being married (β =1.71, 95% CI: 0.56, 2.85), having one previous repair (β =2.14, 95% CI: 0.19, 4.08), high self-esteem (β =1.42, 95% CI: 0.09, 2.74), psychological health (β =0.05, 95% CI: 0.26, 3.79), living with fistula ≥5 years (β =1.82, 95% CI: 0.44, 3.21), high knowledge of risk factors (β =3.12, 95% CI: 1.99, 4.25), and a positive attitude (β =2.33, 95% CI: 1.12, 3.54) were significant predictors of the intent to prevent obstetric fistula recurrence. Conclusion Intent to prevent obstetric fistula recurrence among women with obstetric fistula was low. This indicates an urgent need to create awareness among women with an obstetric fistula on the risk factors of obstetric fistula recurrence, attitudinal changes towards prevention of obstetric fistula recurrence, and the availability of prevention measures.

show abstract

Profile and outcome of patients with recurrent urogenital fistula in a fistula centre in Nigeria

Abstract: The success rate was good. Patients who had previous failed repairs at the fistula centre had better outcomes after the repeat surgeries. Centralizing fistula care will enhance optimal outcomes. It may also boost training and research in this specialty.

Cited by 6 publications

References 22 publications

Predictors of outcomes in patients with repeat surgery for obstetric fistula: a retrospective review

Predictors of outcomes in patients with repeat surgery for obstetric fistula: a retrospective review

Proportions and determinants of successful surgical repair of obstetric fistula in low- and middle-income countries: A systematic review and meta-analysis

The Predictors of Intent to Prevent Obstetric Fistula Recurrence Among Women with Fistula in Ethiopia: A Facility-Based Cross-Sectional Study

Contact Info

Product

Resources

About