Objectives To assess factors influencing short-term outcomes of vesicovaginal fistula (VVF) repairs in community-dwelling women of Liberia, Africa. Methods Forty patients who underwent VVF repairs were analyzed. Primary outcome was continence status at 14 days post repair. Factors influencing continence status were characterized. Results The mean duration of leakage was 9.6 ± 8.3 years, (3 months–28 years). Thirteen (33%) had previous repairs, and 6 (15%) had multiple fistula sites. Twenty-eight (70%) were continent at catheter removal. First time repairs had a higher continence rate compared to women with previous repairs, 78% and 54% respectively (p= 0.15). Seven (47%) juxtaurethral repairs were considered failures, while only one (9%) juxtacervical fistulas remained incontinent (p= 0.069). Controlling for duration of leakage, women with previous repairs were significantly less likely to be continent (p = 0.04; adjusted OR = 0.07; 95% CI: 0.005, 0.83). Conclusions Patients with previous VVF repairs and juxtaurethral fistulae experience lower success rates; surgery remains an effective treatment for many VVF patients.

In children with asymptomatic tethered cord, abnormal preoperative UDS may prompt intervention, while normal UDS do not appear to prevent intervention. There is no significant correlation between abnormal preoperative UDS and abnormal preoperative imaging. Further study is needed to evaluate the utility of this procedure in the preoperative setting in this asymptomatic patient population.

Objective To characterize prevalence and quality of life (QoL) impact of urinary incontinence (UI), fecal incontinence (FI), and pelvic organ prolapse (POP) symptoms in women of Liberia. Methods A questionnaire addressing symptoms and QoL impact of UI, FI and POP was administered to women in a community setting in Ganta, Liberia. Questionnaires were analyzed to determine prevalence rates, QoL impact, and risk factors for these conditions. Results 424 participants were surveyed; 1.7% reported UI, 0.10% reported any form of FI, and 3.3% reported some degree of POP symptoms. QoL responses varied among symptom groups. Previous hysterectomy, cesarean delivery, vaginal deliveries, and body mass index had no significant association with UI, FI, or POP. Participants with UI symptoms were more likely to report FI symptoms (p=0.002). Conclusion Prevalence rates for UI, FI and POP in this population are low; there was a significant association of FI symptoms in subjects with UI.

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