Risk Factors for Urinary Incontinence after Obstetric Vesicovaginal Fistula Closure in Guinea

Balde, Fatoumata Binta; Diallo, Abdoulaye Bobo; Touré, Abdoulaye; Kante, Daouda; Diallo, Tidiane; Lamadine, Alhafiz; Cissé, Demba; Kouadio, Olivier

doi:10.4236/ss.2021.121001

Cited by 4 publications

(9 citation statements)

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“…Collaboration with the teams of Kambou and Kaboré, who have extensive experience in the management of urogenital fistulas in Burkina Faso, could help improve our results [ 10 ]. The rate of residual urinary incontinence in the present study (12%) is similar to that reported in the literature [ 7 , 25 ]. Hillary et al .…”

Section: Discussionsupporting

confidence: 91%

Characteristics of obstetric urogenital fistulas in a regional teaching hospital in Burkina Faso: a retrospective cross-sectional study

Traore¹,

Ouédraogo²,

Kaboré³

et al. 2023

Pan Afr Med J

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Introduction Obstetric fistula (OF) remains a major public health problem in low-income countries. This study aimed to investigate the sociodemographic, clinical, and therapeutic characteristics of obstetric urogenital fistulas in a regional teaching hospital in Burkina Faso. Methods a retrospective cross-sectional study from 1 st January 2015 to 31 st December 2019 included 50 women who underwent OF surgery repair in the regional teaching hospital of Ouahigouya in Burkina Faso. Case identification was completed by self-reported constant urine leakage and was confirmed by clinical assessment. Data on socio-demographic, clinical, and therapeutic characteristics have been collected from the hospital medical records and analyzed. Results the mean age of the patients was 29.40 ± 9.4 years (range 15 -55 years). The majority of patients were in the age group between (15-25) years old (44%). Forty-three patients (86%) were residing in rural areas and forty-seven patients (94%) were housekeepers. Twenty-six patients (52%) were primiparous. The majority of patients had received no prenatal care 29 (58%). The majority of patients had a spontaneous vaginal delivery 36 (72%). The duration of labor was greater than 48 hours in 31 (62%) patients. Vesicovaginal fistulas (VVF) accounted for 80% of cases. Ten (20%) patients had previously undergone surgery for the same fistula. The mean size of the fistulas was 1.8±1.4 cm (range 0.5 - 6 cm). At three months of follow-up, the successful closure rate was 68%. Sixteen (32%) patients have experienced a failure of fistula closure. Conclusion the majority of fistula survivors were women of reproductive age who were living in rural areas and housekeepers. Mothers having no antenatal care, and having prolonged labor were at increased risk of developing OF. The majority of fistulas were simple fistulas and the most common type of OF was VVF. Surgical outcomes showed a high failure rate.

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Section: Discussionsupporting

confidence: 91%

Characteristics of obstetric urogenital fistulas in a regional teaching hospital in Burkina Faso: a retrospective cross-sectional study

Traore¹,

Ouédraogo²,

Kaboré³

et al. 2023

Pan Afr Med J

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“…Although the successful obstetric VVF closure rate is greater than 90%, after successful obstetric VVF repair, patients complain of up to 55% UI [ 7 ]. UI after VVF closure was defined as any involuntary leakage of urine from the vagina that a patient complained about after obstetric VVF repair [ 11 ]. UI after successful obstetric VVF repair can include stress UI, overactive bladder, mixed UI, or bladder voiding disorder [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Despite the highest successful closure of VVF repair, UI is a common and challenging public health problem among patients who underwent VVF repair [ 11 , 13 , 14 ]. Patients with UI experience wetness, odor, and discomfort [ 15 ], which have significant consequences for social and emotional problems such as relationship problems, depression, and suicidal ideation [ 16 ] and can affect women’s quality of life [ 17 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…In SSA, retrospective cohort studies demonstrated that in the Democratic Republic of Congo (DRC), between 2017 and 2019 (4.3%) [ 13 ], in Guinea (13.36%) [ 11 ], in Malawi between September 2011 and December 2014 (24%) [ 24 ]. A retrospective cross-sectional review conducted in Burkina Faso between 2010 and 2016 revealed 11.7% of patients with UI [ 25 ] and in Niger between 2011, 2013 and 2014 (63.9%) [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…These factors included sociodemographic, obstetric, fistula, and perioperative characteristics. For example, a study performed in Guinea demonstrated that the age of the patient, duration of the fistula, presence of Goh type fistulas, shortness of the urethra, and total destruction of the bladder neck were risk factors for UI after obstetric VVF closure [ 11 ]. Another study conducted in Guinea also found that partially or totally damaged urethra status was a contributing factor for post-fistula repair UI [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

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Urinary incontinence following successful closure of obstetric vesicovaginal fistula repair in Southern Ethiopia

Tadesse,

Mekete,

Negese

et al. 2024

BMC Women's Health

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Background Urinary incontinence (UI) after successful closure of obstetric vesicovaginal fistula (VVF) repair is a widely recognized public health problem. However, there is insufficient research evaluating the factors associated with UI after successful obstetric VVF repair in Ethiopia. Objectives The main aim of this study was to assess the magnitude and associated factors of UI following the successful closure of obstetric VVF repair at the Yirgalem Hamlin Fistula Center in the Sidama region of southern Ethiopia. Methods A retrospective cross-sectional analytical study was performed on patients who underwent obstetric VVF repair at the Yirgalem Hamlin Fistula Center between 2016 and 2020. The data were collected from September to October 2021. EPI Data Version 3.1 and SPSS Version 25.0 were used for data entry and analysis. A multivariable binary logistic regression model was used for all variables significant in the bivariate binary logistic analysis to determine the association between the independent variables and outcome variables. The data are presented in tables and figures. Variables with a p-value < 0.05 were considered to be statistically associated with the study outcome. Results In total, 499 study subjects were included. The magnitude of UI after successful closure of obstetric VVF repair was 23.25%. A Goh type 4 fistula (AOR = 4.289; 95% CI 1.431, 12.852), a fistula size > 3 cm (AOR = 8.855; 95% CI 4.786, 16.382), a partially damaged urethra (AOR = 2.810; 95% CI 1.441, 5.479), and a completely destroyed urethra (AOR = 5.829; 95% CI 2.094, 16.228) were found to be significantly associated factors with the outcome variable. Conclusions Nearly one in four patients who had successful closure of obstetric VVF repair at the Yirgalem Hamlin fistula center had UI, which is above the WHO recommendations. The presence of a Goh type 4 fistula, large fistula size, and damaged urethral status significantly affect the presence of UI. Therefore, interventions are necessary to prevent and manage UI among patients who underwent obstetric VVF repair and had a closed fistula.

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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

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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.

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Risk Factors for Urinary Incontinence after Obstetric Vesicovaginal Fistula Closure in Guinea

Cited by 4 publications

References 10 publications

Characteristics of obstetric urogenital fistulas in a regional teaching hospital in Burkina Faso: a retrospective cross-sectional study

Characteristics of obstetric urogenital fistulas in a regional teaching hospital in Burkina Faso: a retrospective cross-sectional study

Urinary incontinence following successful closure of obstetric vesicovaginal fistula repair in Southern Ethiopia

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

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