Women with obstetric fistula in Ethiopia: a 6‐month follow up after surgical treatment

Abstract

Objective To quantify surgical and quality of life outcomes 6 months after obstetric fistula repair.Design A prospective study. Women were examined and questioned at discharge and at follow-up appointment.Setting The Barhirdar Hamlin Fistula Centre, a dedicated unit treating women with obstetric fistula in northern Ethiopia.Population All women admitted to the Barhirdar Hamlin Fistula Centre suffering from vesicovaginal (WF) and rectovaginal fistulae (RVF).Methods All women were asked to return for a follow-up appointment 6 months after surgical treatment. A standardised questionnaire and examination were used and information entered into a database.Main outcomes measures Urinary and anal continence status; extent of return to previous family situation, employment, social activities and reproductive capabilities.Results Continence status at discharge was largely maintained at 6 months and quality of life was improved. Many of those incontinent on discharge improved; a small number apparently cured at discharge had later recurrence of incontinence.Conclusions Surgical treatment for obstetric fistula is successful in maintaining continence and improving quality of life of women at 6-months follow up.

High loss to follow-up following obstetric fistula repair surgery in rural Burundi: is there a way forward?

“…8 In this study, loss to follow-up at 6 months was just under 40%, which is much lower than in our setting. Possible reasons for the very high losses to follow-up in our setting may be related to access, acceptability and/or fi nancial barriers.…”

“…Such outcomes are generally reported to be good, with fi stula closure rates of 73-93% reported from various other African settings, [13][14][15][16][17] compared to 87% in our setting. However, repair breakdowns are known to occur in the 6-month post-operative period, 8 invalidating these hospital discharge outcomes. Given the sequelae that can ensue after fi stula repair, we would emphasise the importance of implementing a system of cohort monitoring of all patients who undergo obstetric surgery for fi stula.…”

“…7 While continence is not always achieved immediately after surgical repair, incontinence can improve or resolve in time post-operatively. 8 All patients at GFC are thus required to attend 3-and 6-month follow-up visits to assess fi stula closure and continence status.…”

Health‐related quality of life among women in rural Bangladesh after surgical repair of obstetric fistula

“…Among those who have undergone surgical repair, health-related quality of life (QOL) is a key issue; however, most studies conducted to date have focused on QOL before rather than after surgery [4,5,7]. In the studies that have assess postsurgical QOL [6,[10][11][12], surgery has been shown to improve social life, physical activity, and psychological condition. However, some women who underwent obstetric fistula repair remained incontinent [10][11][12], and other health problems (e.g.…”

Complex Rectovaginal Fistula—an Experience at a Tertiary Care Centre

“…The most common cause of RVF in developing countries is still obstetric injuries [1,2] with others being operative trauma, radiation injury, inflammatory bowel disease (mostly Crohn's disease), infection and cancer. RVF may be accompanied by considerable social, psychological and sexual dysfunction.…”