Abstract
BackgroundThe prevention and treatment of obstetric fistula still remains a concern and a challenge in low income countries.The objective of this study was to estimate the overall proportions of failure of fistula closure and incontinence among women undergoing repair for obstetric fistula in Guinea and identify its associated factors.MethodsThis was a retrospective cohort study using data extracted from medical records of fistula repairs between 1 January 2012 and 30 September 2013. The outcome was the failure of fistula closure and incontinence at hospital discharge evaluated by a dye test. A sub-sample of women with vesicovaginal fistula was used to identify the factors associated with these outcomes.ResultsOverall, 109 women out of 754 (14.5 %; 95 % CI:11.9–17.0) unsuccessful repaired fistula at discharge and 132 (17.5 %; 95 % CI:14.8–20.2) were not continent.Failure of fistula closure was associated with vaginal delivery (AOR: 1.9; 95 % CI: 1.0–3.6), partially (AOR: 2.0; 95 % CI: 1.1–5.6) or totally damaged urethra (AOR: 5.9; 95 % CI: 2.9–12.3) and surgical repair at Jean Paul II Hospital (AOR: 2.5; 95 % CI: 1.2–4.9).Women who had a partially damaged urethra (AOR: 2.5; 95 % CI: 1.5–4.4) or a totally damaged urethra (AOR: 6.3; 95 % CI: 3.0–13.0) were more likely to experience post-repair urinary incontinence than women who had their urethra intact.ConclusionAt programmatic level in Guinea, caution should be paid to the repair of women who present with a damaged urethra and those who delivered vaginally as they carry greater risks of experiencing a failure of fistula closure and incontinence.
Highlights
The prevention and treatment of obstetric fistula still remains a concern and a challenge in low income countries
Sociodemographic, clinical and fistula characteristics Overall 785 medical records of women who underwent surgical repair for female genital fistula at the three repair hospitals were screened of which 754 records were included in the analyses (Fig. 1)
Factors associated with repair failure Failure of fistula closure In bivariable analysis, we found that mean age at presentation, mode of delivery, vaginal scarring, status of the
Summary
The prevention and treatment of obstetric fistula still remains a concern and a challenge in low income countries. Because of the smell of urine that results, women suffering of fistula are often abandoned by their spouses and relatives, keeping victims in poverty, isolation and depression [6, 7]. These women are frequently exposed to medical complications such as infection, pain, sexual dysfunction and secondary infertility [8, 9]
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