Demographic profile and treatment outcomes of 100 women with obstetric fistula in Niger

Heller, Alison

doi:10.17077/2154-4751.1325

Cited by 3 publications

(5 citation statements)

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“…Following the selection and quality appraisal phases, 79 studies were transferred to the systematic review and meta-analysis phases to determine the pooled proportion of successful surgical repairs of obstetric fistulae and to identify the determinants of successful surgical repair. The minimum proportion of successful recovery, 36%, was reported by Heller et al [ 59 ] in Niger, and a 100% recovery was reported by Sharma et al [ 46 ] in India. The pooled proportion of successful surgical repair of obstetric fistula was determined by meta-analysis among 76 studies, excluding the study by Sharma et al [ 46 ] to avoid the undue outlier effect of 100% recovery.…”

Section: Resultsmentioning

confidence: 91%

“…proportion of successful recovery, 36%, was reported by Heller et al [59] in Niger, and a 100% recovery was reported by Sharma et al [46] in India. The pooled proportion of successful surgical repair of obstetric fistula was determined by meta-analysis among 76 studies, excluding the study by Sharma et al [46] to avoid the undue outlier effect of 100% recovery.…”

Section: Plos Onementioning

confidence: 77%

“…Sensitivity analysis . Sensitivity analyses were conducted by excluding some studies considering the following criteria: outliers [ 18 , 59 , 94 ], studies with small sample size (n < 100), unspecified fistula type, and surgical route. However, none of the analyses significantly changed either the heterogeneity test or the pooled proportion of successful surgical repair ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…The reviewed studies showed a substantially variable repair rate ranging from 36% [59] to 100% [46], which supported the necessity of determining the pooled proportion of obstetric fistula successful surgical repair through meta-analysis. Therefore, this study determined the pooled proportion and revealed a successful surgical repair outcome of 77.85% [95% CI: 75.14; 80.56] for obstetric fistulae in low and middle-income countries.…”

Section: Discussionmentioning

confidence: 97%

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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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Section: Resultsmentioning

confidence: 91%

Section: Plos Onementioning

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

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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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“…Bladder stones cause women abdominal pain and painful urination (as well as more serious health problems), and often must be surgically removed before women are able to undergo fistula repair surgeries. In the neoliberal healthcare terrain of Niamey, within which fistula care is commoditized and outsourced to visiting teams of foreign surgeons, the women I interviewed waited an average of six months and up to six years on hospital grounds to receive operations (see Heller 2017). Surgeries were maddeningly infrequent; long waits and protracted absences from home had serious consequences on women's social lives, often resulting in divorce and the attenuation of social bonds.…”

Section: The Price Of Passingmentioning

confidence: 99%

Transforming Obstetric Fistula through Concealment in Niger

Heller

2018

Human Organization

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Urinary incontinence following successful closure of obstetric vesicovaginal fistula repair in Southern Ethiopia

Tadesse,

Mekete,

Negese

et al. 2024

BMC Women's Health

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Background Urinary incontinence (UI) after successful closure of obstetric vesicovaginal fistula (VVF) repair is a widely recognized public health problem. However, there is insufficient research evaluating the factors associated with UI after successful obstetric VVF repair in Ethiopia. Objectives The main aim of this study was to assess the magnitude and associated factors of UI following the successful closure of obstetric VVF repair at the Yirgalem Hamlin Fistula Center in the Sidama region of southern Ethiopia. Methods A retrospective cross-sectional analytical study was performed on patients who underwent obstetric VVF repair at the Yirgalem Hamlin Fistula Center between 2016 and 2020. The data were collected from September to October 2021. EPI Data Version 3.1 and SPSS Version 25.0 were used for data entry and analysis. A multivariable binary logistic regression model was used for all variables significant in the bivariate binary logistic analysis to determine the association between the independent variables and outcome variables. The data are presented in tables and figures. Variables with a p-value < 0.05 were considered to be statistically associated with the study outcome. Results In total, 499 study subjects were included. The magnitude of UI after successful closure of obstetric VVF repair was 23.25%. A Goh type 4 fistula (AOR = 4.289; 95% CI 1.431, 12.852), a fistula size > 3 cm (AOR = 8.855; 95% CI 4.786, 16.382), a partially damaged urethra (AOR = 2.810; 95% CI 1.441, 5.479), and a completely destroyed urethra (AOR = 5.829; 95% CI 2.094, 16.228) were found to be significantly associated factors with the outcome variable. Conclusions Nearly one in four patients who had successful closure of obstetric VVF repair at the Yirgalem Hamlin fistula center had UI, which is above the WHO recommendations. The presence of a Goh type 4 fistula, large fistula size, and damaged urethral status significantly affect the presence of UI. Therefore, interventions are necessary to prevent and manage UI among patients who underwent obstetric VVF repair and had a closed fistula.

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Demographic profile and treatment outcomes of 100 women with obstetric fistula in Niger

Abstract: Abstract:Introduction: Due to high fertility rates, low access to emergency obstetric care, and the poor quality of that care, obstetric fistula is relatively widespread in Niger.

Cited by 3 publications

References 4 publications

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

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

Transforming Obstetric Fistula through Concealment in Niger

Urinary incontinence following successful closure of obstetric vesicovaginal fistula repair in Southern Ethiopia

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