Childbirth-Associated Fistula and Perineal Tears Repaired on Outreach Campaigns in Remote Democratic Republic of Congo

Paluku, Justin; Bruce, Phoebe; Kamabu, Eugénie Mukekulu; Kataliko, Benjamin Kasereka; Kasereka, Jonathan; Dube, Annie

doi:10.2147/ijwh.s332040

Cited by 3 publications

(2 citation statements)

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“…In the present study, there was a high success rate of OFs repair which was similar to a study reported by other Congolese (71.7%-89.2%) [2,15,24,26,27] and African (77.9%-84.76%) [18,22,28] studies. The success rate after surgical fistula repair varies from centre to centre and is determined by many factors such as fistula site, degree of healing, previous repair attempts, surgical repair technique, surgeon's expertise, equipment and post-operative nursing among others.…”

Section: Discussionsupporting

confidence: 92%

“…Concerning the vesico‐uterine entity, previous studies [24, 25] done in the DRC had already noted that caesarean section accounted for about a quarter of the causes of iatrogenic obstetric fistulas. Several factors can explain this observation in the DRC such as the low proportion of obstetricians who are poorly distributed over the vast territory, the low investment in the continuing education of young doctors who find themselves alone in isolated places, the poor equipment of public hospitals, road infrastructure in continuous deterioration, the inadequate health referencing system, the continuous deterioration of the socio‐sanitary conditions of the Congolese population, etc.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiological, anatomoclinical, and therapeutic profile of obstetric fistula in the Democratic Republic of the Congo: About 1267 patients

Paluku,

Sikakulya,

Furaha

et al. 2024

Tropical Med Int Health

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ObjectiveOur aim is to describe the epidemiological, anatomoclinical and therapeutic profile of obstetric fistula (OF) in the Democratic Republic of the Congo (DRC).MethodologyThis was a descriptive retrospective study that collected 1416 obstetric fistulas in 1267 patients in seven provinces of the DRC, treated between January 2017 and December 2022. The variables studied were epidemiological, anatomoclinical and therapeutic.ResultsThe mean age of patients at the time of surgical repair was 33.2 years (range: 15 and 77 years) and 32.8% of patients were aged between 20 and 29 years. The mean age of the fistula at repair was 10 years (range: 3.5 months and 56 years). At the time of fistula, 61.7% of patients had delivered vaginally and 28.7% by caesarean section and 8.2% of patients had a haemostasis hysterectomy. Labour lasted at least 3 days in 47.3% of these patients for the fistula birth. Deliveries took place either at home (27.4%) or in a health facility (72.6%); 83.6% of newborns resulting from these births had died. Taken as a whole, urogenital fistulas are more common than genito‐digestive fistulas. Urethro‐vaginal (26.2%) and vesico‐uterine (24.7%) anatomoclinical entities were predominant among urogenital fistulas. A total of 1416 fistulas were surgically repaired in 1267 patients. These repairs were successful for 1226 (86.6%) fistulas. The main surgical route used was transvaginal (68.8%).ConclusionIn the DRC, obstetric fistula is common in young adult women. It often results from vaginal delivery, after prolonged labour. Fistula births often result in the death of newborns. Uro‐genital obstetric fistulas are the most frequent with predominance of urethro‐vaginal and vesico‐uterine anatomoclinical entities. Fistulas remain untreated for a long time. Mostly done transvaginally, surgical repair gives a good result.

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