Fistula recurrence, pregnancy, and childbirth following successful closure of female genital fistula in Guinea: a longitudinal study

Délamou, Alexandre; Delvaux, Thérèse; Ayadi, Alison M. El; Tripathi, Vandana; Camara, Bienvenu Salim; Béavogui, Abdoul Habib; Romanzi, Lauri J.; Cole, Bethany; Bouédouno, Patrice; Diallo, Moussa Salifou; Barry, Thierno Hamidou; Camara, Mandian; Diallo, Kindy; Lévêque, Alain; Zhang, Wei Hong

doi:10.1016/s2214-109x(17)30366-2

Cited by 21 publications

(22 citation statements)

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“…Interventions addressed components of postsurgical social reintegration and rehabilitation needs demonstrated in the literature through education, counseling, physical rehabilitation, improving economic stability, and incorporating a full continuum of care approach . However, no one program modeled the holistic approach recommended by authors.…”

Section: Discussionmentioning

confidence: 99%

“…They may require further medical care depending on injury severity and surgical outcomes, and medical support for subsequent pregnancies and births. Longitudinal studies from sub‐Saharan Africa have identified concerning adversity following fistula surgery, including fistula recurrence, persistent fistula‐related symptoms, subsequent fertility challenges, and adverse perinatal outcomes . In Guinea, 16% experienced fistula recurrence by 24 months .…”

Section: Introductionmentioning

confidence: 99%

“…Longitudinal studies from sub‐Saharan Africa have identified concerning adversity following fistula surgery, including fistula recurrence, persistent fistula‐related symptoms, subsequent fertility challenges, and adverse perinatal outcomes . In Guinea, 16% experienced fistula recurrence by 24 months . In Uganda, by 12 months following repair, one‐third had persistent urinary incontinence, 17% weakness, and 9% general pain .…”

Section: Introductionmentioning

confidence: 99%

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Rehabilitation and reintegration programming adjunct to female genital fistula surgery: A systematic scoping review

Ayadi

Délamou

Barr‐Walker

et al. 2020

Intl J Gynecology & Obste

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Background: Female genital fistula is associated with significant physical, psychological, and economic consequences; however, a knowledge and practice gap exists around services adjunct to fistula surgery. Objectives:To examine rehabilitation and reintegration services provided adjunct to genital fistula surgery, map existing programming and outcomes, and identify areas for additional research. . Two reviewers screened articles and extracted data using standardized methods. Selection criteria: Research and programmatic articles describing service provision in addition to female genital fistula surgery were included. Data collection and analysis: Of 3047 published articles and 2623 unpublished documents identified, 26 and 55, respectively, were analyzed.Main results: Programming identified included combinations of health education, physical therapy, social support, psychosocial counseling, and economic empowerment, largely in sub-Saharan Africa. Improvements were noted in physical and psychosocial health. Conclusions:Existing literature supports holistic fistula care through adjunct reintegration programming. Improving the evidence base requires implementing robust study designs, increasing reporting detail, and standardizing outcomes across studies.Increased financing for holistic fistula care is critical for developing and supporting programming to ensure positive outcomes. K E Y W O R D S

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rehabilitation and reintegration programming adjunct to female genital fistula surgery: A systematic scoping review

Ayadi

Délamou

Barr‐Walker

et al. 2020

Intl J Gynecology & Obste

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“…They may also require further medical care depending on the severity of their injuries and surgical outcomes and require healthcare access for subsequent pregnancies and births. Longitudinal studies from sub-Saharan Africa have identified risks of adverse outcome following fistula surgery, including fistula recurrence, persistent fistula-related symptoms, subsequent fertility challenges and adverse perinatal outcomes 11–13. In Guinea, for example, the cumulative incidence of fistula recurrence was 16% at 24 months13.…”

Section: Introductionmentioning

confidence: 99%

“…Longitudinal studies from sub-Saharan Africa have identified risks of adverse outcome following fistula surgery, including fistula recurrence, persistent fistula-related symptoms, subsequent fertility challenges and adverse perinatal outcomes 11–13. In Guinea, for example, the cumulative incidence of fistula recurrence was 16% at 24 months13. In Uganda, by 12 months postsurgery, one-third of women continued to experience urinary incontinence, 17% reported weakness and 9% reported general pain 14.…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation and reintegration programming adjunct to female genital fistula surgery: a scoping review protocol

et al. 2019

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IntroductionFemale genital fistula is a debilitating traumatic injury, largely birth-associated, globally affecting up to 2 million women, mostly in sub-Saharan Africa. Fistula has significant physical, psychological and economic consequences. Women often face challenges in reintegrating and resuming prior roles despite successful surgery. Synthesising the evidence on services adjunct to fistula surgery and their outcomes is important for developing the evidence base for best practices and identifying research priorities. This scoping review seeks to examine the range of rehabilitation and reintegration services provided as adjunct to genital fistula surgery, map the existing programming and outcomes, and identify areas for additional research.Methods and analysisOur scoping review is informed by existing methodological frameworks and will be conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR guidelines. The search strategy will be applied to nine biomedical, public health and social science databases. The initial search was completed on 27 September 2018. Grey literature will be identified through targeted Google searches and from organisational websites identified as relevant by the United Nations Population Fund (UNFPA) Campaign to End Fistula. We will iteratively build our search strategy through term harvesting and review, and search reference lists of reports and articles to identify additional studies. Two reviewers will independently screen titles and abstracts, followed by full-text screening of all potentially relevant articles and standardised data extraction. Articles eligible for inclusion will discuss research or programmatic efforts around service provision in adjunct to surgery among females with genital fistula. Data will be presented in summary tables accompanied by narrative description.Ethics and disseminationEthics approval is not required for a scoping review. Our results can be used to inform policy, serve as support for funding and development of reintegration programmes and highlight areas for subsequent research. Results will be disseminated at relevant conferences and published in a peer-reviewed journal.

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Treatment outcomes of obstetrical fistula surgical repair in low‐ and middle‐income countries: A scoping review

Zeleke,

Welsh,

Abeje

et al. 2024

Intl J Gynecology & Obste

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BackgroundObstetrical fistula is an abnormal opening between the reproductive tract and lower urinary and/or gastrointestinal tract resulting from obstetrical complications, affecting nearly two million women worldwide. It imposes physical, economic, social, and mental consequences on the affected women. Treatment outcomes vary and, mostly, surgical treatment results in improved quality of life and successful subsequent pregnancy for survivors.ObjectivesThe review aimed to chart and examine the treatment outcomes of obstetrical fistula surgical repair in low‐ and middle‐income countries.Search StrategyThis is a scoping review study to identify treatment outcomes of obstetrical fistula surgical repair in low‐ and middle‐income countries. The search was conducted from databases (PUBMED, Embase, CINAHL, Scopus, and Web of Science), and gray literature (Google Scholar, Google, and conference proceedings).Selection CriteriaThe eligibility criteria were constructed using a participant, concept, and context framework and included study types of primary research, reviews, and reports. Studies without full text and in languages other than English were excluded.Data Collection and AnalysisThe relevant characteristics of the included studies were extracted on an Excel spreadsheet and analyzed to chart treatment outcomes.Main FindingsThe review examined the full text of 57 studies on the treatment outcomes of obstetrical fistula. The findings were grouped into two themes: early and late outcomes. The early outcomes included incontinence, surgical‐site infection, urine retention, hemorrhage, and retained catheter. The late outcomes included fistula recurrence, residual incontinence, quality of life, reproductive issues, mental health, family and social support, and financial status.ConclusionThe treatment outcomes of obstetrical fistula can be grouped into short‐term and long‐term outcomes. Although this review found adequate studies for the analysis, most study designs were poor. Stronger studies are recommended in the future to guide policy and decision‐making. We would like to suggest that researchers conduct systematic reviews and meta‐analyses independently for short‐term and long‐term outcomes.

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Fistula recurrence, pregnancy, and childbirth following successful closure of female genital fistula in Guinea: a longitudinal study

Abstract: Belgian Development Cooperation (DGD), Institute of Tropical Medicine of Antwerp (ITM), and Maferinyah Training and Research Center in Rural Health (Guinea).

Cited by 21 publications

References 40 publications

Rehabilitation and reintegration programming adjunct to female genital fistula surgery: A systematic scoping review

Rehabilitation and reintegration programming adjunct to female genital fistula surgery: A systematic scoping review

Rehabilitation and reintegration programming adjunct to female genital fistula surgery: a scoping review protocol

Treatment outcomes of obstetrical fistula surgical repair in low‐ and middle‐income countries: A scoping review

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