524 Doctor! Will I be dry? Factors determining recurrence after vesicovaginal fistula repair

Abdullah, Aziz; Javed, Atif; Syed, Sher Shah; Farooqui, N

doi:10.1016/s1569-9056(12)60521-1

Cited by 3 publications

(2 citation statements)

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“…From fistula-related factors, women with larger fistula sizes (> 3cm) were 76% less likely to achieve successful surgical repair outcomes than women with small fistulae. Likewise, women whose fistulae were classified as type II and above based on Goh [ 21 , 38 , 42 ] and Waaldijk [ 49 , 50 , 67 , 74 ] classification methods were 58% less likely to have successful surgical repair outcome than women with type I fistulae. Patients whose urethral status was partially or totally damaged were 63% less likely to achieve successful surgical repair than a patient who had an intact urethra.…”

Section: Resultsmentioning

confidence: 99%

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Proportions and determinants of successful surgical repair of obstetric fistula in low- and middle-income countries: A systematic review and meta-analysis

Zeleke,

Welsh,

Abeje

et al. 2024

PLoS ONE

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Background Obstetric fistula is a serious and debilitating problem resulting from tissue necrosis on the reproductive and urinary and/or lower gastrointestinal tract organs due to prolonged labor. Primary studies of the treatment of obstetric fistulae report significantly variable treatment outcomes following surgical repair. However, no systematic review and meta-analysis has yet estimated the pooled proportion and identified the determinants of successful obstetric fistula surgical repair. Objective To estimate the proportion and identify the determinants of successful surgical repair of obstetric fistulae in low- and middle-income countries. Methods The protocol was developed and registered at the International Prospective Register of Systematic Reviews (ID CRD42022323630). Searches of PubMed, Embase, CINAHL, Scopus databases, and gray literature sources were performed. All the accessed studies were selected with Covidence, and the quality of the studies was examined. Finally, the data were extracted using Excel and analyzed with R software. Results This review included 79 studies out of 9337 following the screening process. The analysis reveals that 77.85% (95%CI: 75.14%; 80.56%) of surgical repairs in low and middle-income countries are successful. Women who attain primary education and above, are married, and have alive neonatal outcomes are more likely to have successful repair outcomes. In contrast, women with female genital mutilation, primiparity, a large fistula size, a fistula classification of II and above, urethral damage, vaginal scarring, a circumferential defect, multiple fistulae, prior repair and postoperative complications are less likely to have successful repair outcomes. Conclusion The proportion of successful surgical repairs of obstetric fistula in low and middle-income countries remains suboptimal. Hence, stakeholders and policymakers must design and implement policies promoting women’s education. In addition, fistula care providers need to reach and manage obstetric fistula cases early before complications, like vaginal fibrosis, occur.

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