A comparison of quality of life of obstetric fistula survivors in Zimbabwe before and after surgical treatment

Abstract

Background In Zimbabwe, repair of obstetric fistula was established as a public health intervention in 2015. The aim of this study was to assess the quality life of obstetric fistula survivors before and after surgical repair of the fistula. Methods A longitudinal, before and after cohort study was conducted using the WHOQOL-BREF tool to assess quality of life before and after surgical treatment of obstetric fistula. The tool assess general health, experience of life in general, physical health, psychological health, social and environmental health. Data were analyzed using SPSS version 16.0 for descriptive measures and significance. Results Of the 29 women who came for obstetric fistula repair at the center in November and December 2019, 26 were enrolled into the study. All participants had transvaginal fistula repair and 24 had successful repair i.e. the fistulas were closed. Two of them still had stress incontinence by the time of data collection. The post treatment mean scores, using the WHOQOL assessment tool, on physical, psychological, social, environmental and general health significantly improved from the pretreatment mean scores. There was no significant change in some facets of the quality of life domains such as financial resources, opportunities for participation in leisure activities and dependence on medicines. Conclusions This study concluded that surgical treatment of obstetric fistula improves the quality of life of survivors significantly and recommends that untreated fistula survivors be identified and linked to care and treatment.

Access to High Quality Surgical Repair Services is a Fundamental Right of Patients with Obstetric Fistulas: A Study on Quality of Life Data in the Democratic Republic of the Congo

“…Psychologically, our study demonstrates a substantial improvement in QoL, with a significant increase from pre-operative to post-operative scores. This aligns with previous research by Chimamise et al 5 and emphasizes the psychological benefits of successful OF surgery. The relief from urinary/fecal incontinence, malodors, and other OF-related symptoms allows patients to regain concentration, self-confidence, self-esteem, positive emotions, and a healthier self-image, all contributing to improved psychological health.…”

“…These findings are consistent with previous research demonstrating the positive relationship between OF reconstructive surgery and QoL from a social perspective. 5 , 6 , 11 , 13 , 14 OF patients often experience discrimination, stigmatization, and rejection within their families and communities, 2 , 15 compromising their social well-being. Successful surgical repair enables these patients to reintegrate socially, participate in familial and community activities, and regain self-confidence.…”

“…Successful surgical repair enables these patients to reintegrate socially, participate in familial and community activities, and regain self-confidence. 5 …”

“…These findings align with prior research emphasizing the effectiveness of OF reconstructive surgery in enhancing the physical well-being of patients. 5,6,[11][12][13] OF-related symptoms, such as urinary and/or fecal incontinence, recurrent infections, and pelvic pain, can severely limit mobility and daily autonomy, leading to a deteriorating cycle where each symptom exacerbates physical decline. Successful surgical repair addresses these physical symptoms of incontinence, pain, recurrent infections, and limited mobility, thereby improving QoL.…”

“…4 There have been a few previous studies examining the impact of surgical OF repair on QoL among women with OF. For example, Chimamise et al 5 showed a significant improvement in QoL after surgical repair among OF patients in Zimbabwe. Similarly, Debela et al 6 in Ethiopia reported that all areas of QoL showed significant improvement after successful SROF.…”