An audit of obstetric fistulae in a teaching hospital in South Africa

Ramphal, Suran; Kalane, G; Fourie, T; Moodley, J

doi:10.1258/td.2007.070087

Cited by 4 publications

(1 citation statement)

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“…It is difficult to compare the success rates between the two studies, as Lee et al had no patients with complex UGFs as seen in our study. Furthermore, most patients in our study were from a poor socioeconomic background and often presented late to hospital, as also reported by Ramphal et al [15] The abdominal route of fistula repair predominated in our study (42 abdominal v. 25 vaginal). This was determined by the following factors, set as prerequisites for determining the operative route of repair in our unit: the abdominal route is preferred if the fistula site is in close proximity to, or involves, the ureter, the trigone area of the bladder or the uterus, or if there are multiple fistulas, a contracted vagina or poor vaginal access to the fistula site.…”

Section: Discussionsupporting

confidence: 77%

A clinical audit of female urinary incontinence at a urogynaecology clinic of a tertiary hospital in Durban, South Afric

2015

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RESEARCHBackground. Urinary incontinence (UI) is a common condition with an increasing prevalence worldwide. Although it is not a lifethreatening condition, it can be very disabling. Objective. To describe the clinical profiles, risk factors, diagnosis, treatment and clinical outcomes of women with different subtypes of UI who attended a tertiary hospital in Durban, South Africa. Methods. A retrospective chart review was performed. A structured data form was used to obtain the relevant information. Results. Seven hundred and fifty-eight of 945 charts with a diagnosis of UI were analysed. Stress urinary incontinence (SUI) was the most common subtype of UI (30%). The mean (standard deviation (SD)) age was 50.9 (15.2) years; mean (SD) parity 2.8 (1.4) and mean (SD) body mass index 29.2 (5.3) kg/m 2 . Indians (n=366, 48.3%) were the predominant racial group; black Africans constituted 32.7% (n=248). Mid-urethral tape was the preferred surgical treatment for SUI (n=134, 62.0%). Urge UI was treated mainly with pharmaceutical agents (n=138, 74.2%) with physiotherapy as adjunctive therapy. Urogenital fistulas were repaired via laparotomy (n=42, 53.9%) and vaginally (n=25, 32%). Mid-urethral tapes and Burch colposuspension had success rates of 97% and 83.3%, respectively. Both laparotomy and vaginal fistula repairs had success rates of 95%. Conclusions. Stress UI was the most common subtype of UI observed in this study. Patients were predominantly Indians and overweight or obese. The majority of patients with urogenital fistulas were black Africans. Surgical outcomes at our centre were in keeping with those in international reports.

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Section: Discussionsupporting

confidence: 77%