Dataset Information

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study.

ABSTRACT:

Objective

We evaluated residual incontinence, depression, and quality of life among Malawian women who had undergone vesicovaginal fistula (VVF) repair 12 or more months previously.

Design

Prospective cohort study.

Setting

Fistula Care Centre in Lilongwe, Malawi.

Population

Women who had undergone VVF repair in Lilongwe, Malawi at least 12 months prior to enrolment.

Methods

Self-report of urinary leakage was used to evaluate for residual urinary incontinence; depression was evaluated with the Patient Health Questionnaire-9; quality of life was evaluated with the King's Health Questionnaire.

Main outcome measures

Prevalence and predictors of residual incontinence, quality of life scores, and prevalence of depression and suicidal ideation.

Results

Fifty-six women (19.3%) reported residual urinary incontinence. In multivariable analyses, predictors of residual urinary incontinence included: pre-operative Goh type 3 [adjusted risk ratio (aRR) 2.82; 95% confidence interval (CI) 1.61-5.27) or Goh type 4 1.08-2.78), positive postoperative cough stress test (aRR = 2.42; 95% CI 1.24-4.71) and the positive 1-hour postoperative pad test (aRR = 2.20; 95% CI 1.08-4.48). Women with Goh types 3 and 4 VVF reported lower quality of life scores. Depressive symptoms were reported in 3.5% of women; all reported residual urinary incontinence.

Conclusions

While the majority of women reported improved outcomes in the years following surgical VVF repair, those with residual urinary incontinence had a poorer quality of life. Services are needed to identify and treat this at-risk group.

Tweetable abstract

Nearly one in five women reported residual urinary incontinence at follow up, 12 or months after vesicovaginal fistula repair.

SUBMITTER: Kopp DM

PROVIDER: S-EPMC6510632 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study.

Kopp D M DM Tang J H JH Bengtson A M AM Chi B H BH Chipungu E E Moyo M M Wilkinson J J

BJOG : an international journal of obstetrics and gynaecology 20181227 7

<h4>Objective</h4>We evaluated residual incontinence, depression, and quality of life among Malawian women who had undergone vesicovaginal fistula (VVF) repair 12 or more months previously.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Fistula Care Centre in Lilongwe, Malawi.<h4>Population</h4>Women who had undergone VVF repair in Lilongwe, Malawi at least 12 months prior to enrolment.<h4>Methods</h4>Self-report of urinary leakage was used to evaluate for residual urinary incontinence; ...[more]

PMID: 30461170

Similar Datasets

Project description:BACKGROUND:Obstetric fistula (OF) is a maternal morbidity associated with high rates of stillbirth, amenorrhea, and sexual dysfunction. Limited data exists on the reproductive outcomes of women in the years following a fistula repair. The objective of this study is to describe the fertility outcomes and family planning practices in a population of Malawian women 1-4 years after fistula repair. METHODS:Women who had enrolled into a clinical database of OF patients and undergone OF repair between January 1, 2012 and July 31, 2014 were recruited and enrolled to complete a home-based survey of their demographic and reproductive health data 1-4 years after their repair. Pregnancy, amenorrhea, and sexual function were described using frequency analysis, and we compared antimüllerian hormone (AMH) concentrations between women with menses or pregnancy with women with amenorrhea or no pregnancy using Wilcoxon rank sum tests. RESULTS:Of 297 women with a prior OF repair, 148 had reproductive potential and were included in this analysis. Overall 30 women of these women (21%) became pregnant since their fistula repair, with most pregnancies ending with cesarean delivery. Of the 32 women who were amenorrheic at the time of repair, 25 (78.1%) had resumption of menses. Only 11 (8.6%) of sexually active women reported dyspareunia, and among women who were not trying to conceive, 53.1% were currently using a method of family planning. No significant differences were found in AMH concentrations between those who were pregnant or had menses versus those without pregnancy or menses, respectively. CONCLUSIONS:In this long-term follow-up study of women after OF repair, many women were able to achieve a pregnancy with a live birth, have normal menses, be sexually active, and access contraception. These achievements will further assist a population of women whose reintegration and restoration of dignity is closely tied to their ability to achieve their reproductive goals. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT02685878 .

Dataset Information

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study.

Objective

Design

Setting

Population

Methods

Main outcome measures

Results

Conclusions

Tweetable abstract

Publications

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study.

Similar Datasets

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