Obstetric Fistula in Context

Wall, L. Lewis

doi:10.1007/978-3-031-06314-5_4

Cited by 2 publications

(3 citation statements)

References 57 publications

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“…Obstetric fistula (OF) is defined as an abnormal communication between the urinary tract and the genital tract (urogenital fistula) or between a woman's anorectal tract and genital tract (genito-digestive fistula), resulting primarily from prolonged and obstructed labour resulting in uncontrolled loss of urine and/or stool through the vagina [1][2][3]. It is currently a real public health problem in developing countries [2].…”

Section: Introductionmentioning

confidence: 99%

“…It is currently a real public health problem in developing countries [2]. It mainly affects women living in poor countries in sub-Saharan Africa (SSA) and Asia, with insufficient access to prenatal and intrapartum health care [1,3]. It results in physical, psychological, and social consequences that surgical repair alone is not enough to resolve [3].…”

Section: Introductionmentioning

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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…OF is characterized by an abnormal communication between the genital tract and the urinary or gastrointestinal tract, leading to persistent urinary or fecal incontinence. Research has documented the enormous physical and psychosocial consequences of living with OF, 1 including the impact that persistent incontinence has on ones’ quality of life (QoL). OF patients are often exposed to social stigma, isolation, and psychological distress, 2 which negatively impacts their QoL and wellbeing.…”

Section: Introductionmentioning

confidence: 99%

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

Paluku,

Bartels,

Kataliko

et al. 2024

IJWH

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Purpose The aim of this study was to assess quality of life (QoL) using the WHOQOL-BREF questionnaire among obstetric fistula (OF) patients before and after surgical repair of OF (SROF). Methods A longitudinal cohort study was conducted between November 2022 and October 2023 in the Democratic Republic of the Congo (DRC) among OF patients to assess their QoL before and after SROF. A systematic sampling technique was used to recruit a total of 158 OF patients. The WHOQOL-BREF questionnaire assessed general health, life experience, as well as physical, social, psychological, and environmental domains. Results The mean age among the 158 respondents was 33.51 ± 9.63 years, and 77.85% of them lived in rural areas. In terms of surgical outcomes, 80.38% had closure of the OF with regained continence, 5.7% had closure of the OF with persistent incontinence, and 13.9% had a failed surgical repair. Overall mean QoL scores were higher after OF surgical repair (3.83, standard deviation [SD]=0.89) in comparison to pre-operative (1.58, SD=0.63) (p<0.001). These QoL improvements included physical (mean score 66.32 post-surgery versus 28.37 before, p<0.001), social (mean score 64.92 post-surgery versus 27.90 before, p<0.001), psychological (mean score 68.09 post-surgery versus 21.28 before, p<0.001), environmental (mean score 48.41 post-surgery versus 16.91 before p<0.001), and general domains. Patients with a successful OF repair had a better QoL score than those with a closed fistula but ongoing incontinence or those for whom surgery failed to close the fistula. Conclusion The present study showed that among OF patients, all QoL domains were impaired before surgical repair and significantly improved after surgery. Successful OF closure alleviates the consequences of OF and helps to restore patients’ wellbeing. Our findings call for improved access to high-quality surgical repair services as a fundamental right for OF patients.

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Obstetric Fistula in Context

Cited by 2 publications

References 57 publications

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

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

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

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