Prognostic factors and long‐term outcomes of obstetric fistula care using the Tanguiéta model

Benski, Anne Caroline; Delavy, Martine; Rochat, Charles-Henry; Viviano, Manuela; Catarino, Rosa; Elsig, Valérie; Doulougou, Abdoulaye; Petignat, Patrick; Vassilakos, Pierre

doi:10.1002/ijgo.13071

Cited by 4 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This review includes studies from 24 different African nations. Of the total, 4 (4.71%) were from Northern Africa ( 26 – 29 ), 10 (11.76%) were from Central Africa ( 13 , 16 , 30 – 37 ), 31 (34.12%) were from West Africa ( 38 – 68 ), and 40 (47.06%) ( 19 , 69 – 107 ) were from East Africa ( Figure 2 ). The majority of the included articles were from Sub-Saharan African countries such as Ethiopia, Nigeria, and the Democratic Republic of Congo.…”

Section: Resultsmentioning

confidence: 99%

Successful surgical closure and continence rate of obstetric fistula in Africa: systematic review and meta-analysis

Kumsa,

Mislu,

Arage

et al. 2023

Front. Glob. Womens Health

View full text Add to dashboard Cite

BackgroundA female genital fistula is an abnormal connection between a woman's reproductive tract and her urinary tract or rectum. While numerous studies have aimed to determine the success rate of obstetric fistula closure in different health settings, there remains a significant scarcity of data on closure success rates and incontinence rates for various types of fistulas at the regional and sub-regional levels. The success rate reflects the continent's healthcare setup in regard to the World Health Organization standards. Thus, this study aims to determine the success of surgical closure and the continence rate of obstetric fistula in Africa.MethodsThis systematic review and meta-analysis review includes studies conducted up to February 2023. Search engines like EMBBASE, Medline, Google, PubMed, Google Scholar, African Journals Online, and ScienceDirect databases were utilized to find articles. The Joanna Briggs Institute critical evaluation checklist was used to evaluate the quality of our review, which was conducted in accordance with PRISMA criteria. Heterogeneity was indicated by a p-value for I2 statistics of less than 0.05. Publication bias was assessed using the Egger regression asymmetry test. Data were entered into Microsoft Excel and analyzed using STATA 16.ResultThis review includes 85 studies. A total of 24 countries from East, West, Central, North, and Southern African sub-regions were included. The overall pooled estimated rate of successful obstetric fistula closure is 86.15 (95% CI: 83.88–88.42). Moreover, the pooled estimated rate of successfully closed vesico-vaginal fistulas but with ongoing or residual incontinence (wet) was revealed as 13.41% (95% CI: 11.15–15.68). The pooled estimated rate of successfully closed rectovaginal fistulas and combined VVF and RVF are 91.06% (95% CI: 86.08–96.03) and 62.21% (95% CI: 48.94–75.49), respectively.ConclusionsThe rate of successful obstetric fistula closure in Africa is 86.15, which is higher than the WHO target. However, the surgical closure rate of a combined VVF and RVF is 62.2%, which is significantly lower than the WHO target.

show abstract

Section: Resultsmentioning

confidence: 99%

Successful surgical closure and continence rate of obstetric fistula in Africa: systematic review and meta-analysis

Kumsa,

Mislu,

Arage

et al. 2023

Front. Glob. Womens Health

View full text Add to dashboard Cite

show abstract

“…From fistula-related factors, women with larger fistula sizes (> 3cm) were 76% less likely to achieve successful surgical repair outcomes than women with small fistulae. Likewise, women whose fistulae were classified as type II and above based on Goh [ 21 , 38 , 42 ] and Waaldijk [ 49 , 50 , 67 , 74 ] classification methods were 58% less likely to have successful surgical repair outcome than women with type I fistulae. Patients whose urethral status was partially or totally damaged were 63% less likely to achieve successful surgical repair than a patient who had an intact urethra.…”

Section: Resultsmentioning

confidence: 99%

Section: Plos Onementioning

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

Treatment outcomes of obstetrical fistula surgical repair in low‐ and middle‐income countries: A scoping review

Zeleke,

Welsh,

Abeje

et al. 2024

Intl J Gynecology & Obste

View full text Add to dashboard Cite

BackgroundObstetrical fistula is an abnormal opening between the reproductive tract and lower urinary and/or gastrointestinal tract resulting from obstetrical complications, affecting nearly two million women worldwide. It imposes physical, economic, social, and mental consequences on the affected women. Treatment outcomes vary and, mostly, surgical treatment results in improved quality of life and successful subsequent pregnancy for survivors.ObjectivesThe review aimed to chart and examine the treatment outcomes of obstetrical fistula surgical repair in low‐ and middle‐income countries.Search StrategyThis is a scoping review study to identify treatment outcomes of obstetrical fistula surgical repair in low‐ and middle‐income countries. The search was conducted from databases (PUBMED, Embase, CINAHL, Scopus, and Web of Science), and gray literature (Google Scholar, Google, and conference proceedings).Selection CriteriaThe eligibility criteria were constructed using a participant, concept, and context framework and included study types of primary research, reviews, and reports. Studies without full text and in languages other than English were excluded.Data Collection and AnalysisThe relevant characteristics of the included studies were extracted on an Excel spreadsheet and analyzed to chart treatment outcomes.Main FindingsThe review examined the full text of 57 studies on the treatment outcomes of obstetrical fistula. The findings were grouped into two themes: early and late outcomes. The early outcomes included incontinence, surgical‐site infection, urine retention, hemorrhage, and retained catheter. The late outcomes included fistula recurrence, residual incontinence, quality of life, reproductive issues, mental health, family and social support, and financial status.ConclusionThe treatment outcomes of obstetrical fistula can be grouped into short‐term and long‐term outcomes. Although this review found adequate studies for the analysis, most study designs were poor. Stronger studies are recommended in the future to guide policy and decision‐making. We would like to suggest that researchers conduct systematic reviews and meta‐analyses independently for short‐term and long‐term outcomes.

show abstract

Prognostic factors and long‐term outcomes of obstetric fistula care using the Tanguiéta model

Cited by 4 publications

References 12 publications

Successful surgical closure and continence rate of obstetric fistula in Africa: systematic review and meta-analysis

Successful surgical closure and continence rate of obstetric fistula in Africa: systematic review and meta-analysis

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

Treatment outcomes of obstetrical fistula surgical repair in low‐ and middle‐income countries: A scoping review

Contact Info

Product

Resources

About