Sexual activity among Nigerian women following successful obstetric fistula repair

Anzaku, Ajen Stephen; Lengmang, Sunday J.; Mikah, S; Shephard, Steven N.; Edem, Bassey E.

doi:10.1002/ijgo.12083

Cited by 25 publications

(17 citation statements)

References 22 publications

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“…Studies assessing patient-focused outcomes of surgery have identified significant short-term improvements including enhanced overall quality of life [21], psychological status [22], social functioning [23,24] and economic status [25]. However, they also report significant long-term challenges, including persistent residual incontinence [20,26,27], pain and weakness [21,28], and sexual and fertility complications [5,21,[29][30][31]. Lingering physical problems such as these reduce women's ability to resume social roles, making them less likely to consider themselves to have recovered [3, 21, 25, 32,] and placing them at greater risk of continued poor mental health [28,33,34].…”

Section: Introductionmentioning

confidence: 99%

Trajectories of women's physical and psychosocial health following obstetric fistula repair in Uganda: a longitudinal study

Ayadi

Barageine

Korn

et al. 2018

Tropical Med Int Health

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Objectives To explore trajectories of physical and psychosocial health, and their interrelationship, among women completing fistula repair in Uganda for 1 year post‐surgery. Methods We recruited a 60‐woman longitudinal cohort at surgical hospitalisation from Mulago Hospital in Kampala Uganda (Dec 2014–June 2015) and followed them for 1 year. We collected survey data on physical and psychosocial health at surgery and at 3, 6, 9 and 12 months via mobile phone. Fistula characteristics were abstracted from medical records. All participants provided written informed consent. We present univariate analysis and linear regression results. Results Across post‐surgical follow‐up, most women reported improvements in physical and psychosocial health, largely within the first 6 months. By 12 months, urinary incontinence had declined from 98% to 33% and general weakness from 33% to 17%, while excellent to good general health rose from 0% to 60%. Reintegration, self‐esteem and quality of life all increased through 6 months and remained stable thereafter. Reported stigma reduced, yet some negative self‐perception remained at 12 months (mean 17.8). Psychosocial health was significantly impacted by the report of physical symptoms; at 12 months, physical symptoms were associated with a 21.9 lower mean reintegration score (95% CI −30.1, −12.4). Conclusions Our longitudinal cohort experienced dramatic improvements in physical and psychosocial health after surgery. Continuing fistula‐related symptoms and the substantial differences in psychosocial health by physical symptoms support additional intervention to support women's recovery or more targeted psychosocial support and reintegration services to ensure that those coping with physical or psychosocial challenges are appropriately supported.

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Section: Introductionmentioning

confidence: 99%

Trajectories of women's physical and psychosocial health following obstetric fistula repair in Uganda: a longitudinal study

Ayadi

Barageine

Korn

et al. 2018

Tropical Med Int Health

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“…Sexuality is an important component of women's overall well-being, with quality of life and sexual dysfunction contributing to personal and interpersonal stress; this could be especially important for women with genital tract injuries from either obstetric trauma or surgical interventions as one of the major causes of rectovaginal fistula [34]. Given that patient mental health and social functioning appear to improve following surgical fistula repair, it is essential for patients to be referred for surgery in a timely manner following obstructed labor [13].…”

Section: Discussionmentioning

confidence: 99%

Women's Experiences of Rectovaginal Fistula: An Ethno- Religious Experience

Nezhad

Jalali

Karimi

2020

Preprint

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Background: Obstetric fistulas are one of the most tragic injuries that occur after difficult, prolonged childbirth without timely intervention. These fistulas cause discomfort to patients and result in emotional, social, and even physical suffering. The aim of the present study was to explore the experiences of women with rectovaginal fistula in Kamyaran city, in Kurdestan province, west of Iran. Methods: In a phenomenological study, 16 patients, healthcare personnel and patients' families were investigated. Purposive sampling was performed and Study participants were interviewed in-depth semi-structured interviews. All interviews were audio-recorded, transcribed verbatim (word by word) and analyzed by Colaizzi's method. In order to determine the validity of the study, Lincoln and Guba’s criteria, which include credibility, dependability, transferability, and confirmability, were considered. Results: Five general themes and ten sub-themes emerged after investigating interviews. Themes include religious harassment the sub-theme of being defiled), fail (subthemes of loss and negative attitudes, disrupted sex (the subtheme of sexual dissatisfaction), consequence (three subthemes of sleep disturbance, mental crisis, and isolation), and ultimately panic (three subthemes of humiliation, secrecy, and fear). Conclusion: The rectovaginal fistula is a complex and multifaceted problem with social, individual, familial, religious, and ethnic-environmental dimensions, so there is no simple solution to interact with this problem and there is a need to find a solution, considering the dimensions of the problem and plan for help these patients cope with their disease, and take steps to fully treat it.

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“…Thus, they avoid risky behaviours including sexual intercourse and childbirth subsequently resulting in marital conflicts. 15,16 Accordingly, they fear penetrative intercourse due to a narrowed vagina. 16 Their opportunities for earning a living are also minimal.…”

Section: Challenges To the Rehabilitation Of Obstetric Fistula Patientsmentioning

confidence: 99%

“…15,16 Accordingly, they fear penetrative intercourse due to a narrowed vagina. 16 Their opportunities for earning a living are also minimal. 8,17,18 Such challenges are not unique to Sub-Saharan countries but also in South Asia.…”

Section: Challenges To the Rehabilitation Of Obstetric Fistula Patientsmentioning

confidence: 99%

“…8,15 The issues around sexual dysfunction and dyspareunia should be incorporated in rehabilitation programs. 16 A study by Wilson et al in Tanzania pointed out the need for use of a cognitive behaviour framework in the rehabilitation process. The cognitive behaviour framework addresses depressive symptoms, stigma, promotes social skills and emphasizes social support.…”

Section: Strategies For the Rehabilitation Of Obstetric Fistula Patiementioning

confidence: 99%

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The persistent challenges and strategies for effective rehabilitation among obstetric fistula patients at Kitovu Mission Hospital, Uganda: a qualitative study

Atuhaire

Odukogbe

Mugisha

et al. 2020

Int J Community Med Public Health

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Background: Obstetric fistula poses a great physical, psychosocial and economic burden to girls and women in low and middle-income countries. About 53% of the obstetric fistula patients may live with untreated fistula for more than a year, thus patients require rehabilitation as they await repair and after repair. Little qualitative research exists on rehabilitation particularly on the challenges and effective strategies that inspired this study.Methods: A cross-sectional qualitative research approach used in-depth interviews and key informant interviews to collect data from 10 obstetric fistula patients who had been registered by the Urogynecology Department, Kitovu Hospital within two years before the time of data collection status and 12 key informants who include hospital staffs engaged in the management of fistula and patients’ partners who were involved in caregiving. Data were analyzed thematically using ATLAS.ti 7.5.Results: The major constraints encountered during rehabilitation were limited resources for practice, inadequate counseling especially among immediate relatives, and inadequate capital for self-sustainability and limited employment opportunities. Key informants also mentioned the issue of limited resources, budget constraints, inadequate supervision and follow up of patients. Only one patient who had not had fistula repair had knowledge of rehabilitation. To address the challenges, the participants suggested the need for rehabilitation despite repair status. They required more knowledge about sustainable livelihood programs and cash grants.Conclusions: The patients identified socioeconomic, institutional and political challenges to their rehabilitation. They emphasized the need for improved political commitment, adequate budget, and resource allocation and regular support supervision to ensure their effective rehabilitation.

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Sexual activity among Nigerian women following successful obstetric fistula repair

Abstract: Following obstetric fistula repair, many women experienced difficulty engaging in penetrative vaginal intercourse and reported sexual dysfunction. Management of sexual dysfunction should be part of fistula rehabilitation programs.

Cited by 25 publications

References 22 publications

Trajectories of women's physical and psychosocial health following obstetric fistula repair in Uganda: a longitudinal study

Trajectories of women's physical and psychosocial health following obstetric fistula repair in Uganda: a longitudinal study

Women's Experiences of Rectovaginal Fistula: An Ethno- Religious Experience

The persistent challenges and strategies for effective rehabilitation among obstetric fistula patients at Kitovu Mission Hospital, Uganda: a qualitative study

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