The immediate management of fresh obstetric fistulas

Waaldijk, Kees

doi:10.1016/j.ajog.2004.02.020

Cited by 134 publications

(97 citation statements)

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“…[7] The very poor, young, illiterate, rural girls and women have been associated with obstetric fistulas in the developing countries. [8] Extensive publications [9][10][11][12] already exist on the epidemiological characteristics and surgical management of the condition but there is very little on the patient understanding of the condition. Such information is essential for effective preventive measures and strategies especially for cases of reoccurrence.…”

Section: Introductionmentioning

confidence: 99%

Vesicovaginal fistula: Do the patients know the cause?

Hassan

Ekele

2009

Ann Afr Med

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Background: So much has been written on vesicovaginal fi stula (VVF) but there is little on the patients' perspective of the condition. The objectives of this study were to determine the knowledge of patients who have developed VVF on the causes of the fi stula and their attitude toward measures that would prevent future occurrence. Methods: The questionnaire-based survey was conducted on VVF patients on admission from June to August 2003 at Maryam Abacha Women and Children Welfare Hospital, Sokoto, Nigeria. The case notes of the patients were reviewed after the interview to match the responses from the patients with those documented in the folders. Focus group discussions were held with the maternity staff to ascertain the content and quality of existing counseling. Results: One hundred and thirty patients were studied out of which 121 (93%) had no formal education. Teenagers constituted 37%, while 57% were primiparae. Thirty-fi ve (27%) patients were divorced or separated because of the VVF. There were seven cases of recurrence after a previous successful repair. Prolonged obstructed labor was the cause of the VVF in 110 (85%) patients and 77 (70%) correctly attributed their problem to the prolonged labor. The 33 patients who could not identify the prolonged obstructed labor as the cause either attributed their condition to God/destiny or to the operation that was done to relief the obstruction and therefore would not have hospital delivery in their subsequent pregnancies. From the focus group discussions, it was confi rmed that pre and post-operative counseling were inadequate. Conclusion: Even though majority (70%) of the patients knew the cause of their fi stula from the health talks, some (32%) would still not change from risky obstetric behavior. Mandatory provision of accurate and appropriate information and education to all VVF patients and their relatives or spouses by trained counselors should be ensured. Such information and education should emphasize the etiology and management of obstetric fi stula in order to prevent a recurrence.

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Section: Introductionmentioning

confidence: 99%

Vesicovaginal fistula: Do the patients know the cause?

Hassan

Ekele

2009

Ann Afr Med

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“…In a conducted in Niger, most women with obstetric fistula give birth at home [8]. This is different from EDHS, 2005 which shows (86%) women with obstetric fistula gave birth at home [17]. This might be due to the awareness created by government and health sector about the importance of giving birth at health institution through media and health extension worker.…”

Section: Discussionmentioning

confidence: 39%

“…According to the finding of this study, 69% of women with obstetric fistula were under 19 years when they were married. Similarly a study conducted in Zambia and Nigeria showed that 50-80% of women with obstetric fistula were under age of 20 year when they get married [17]. This indicates that the problem of early marriage is still present.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study of Obstetric Fistula among Clients Admitted To Fistula Unit Jimma University Specialized Hospital, Oromia Region, South West Ethiopia

Zegeye¹,

Dagne²

2017

J Women's Health Care

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“…Dependent variable: Recovery from Fistula Surgery: Status of recovery from Fistula surgery (primary repair) is defined using two indicators, status of Fistula closure and patient's post-repair stress incontinence by using Andrew Browning's method [40][41][42].…”

Section: Study Variablesmentioning

confidence: 99%

Predictors of Time to Recovery from a Surgical Repair of Obstetric Fistula at Mekelle Hamlin Fistula Center, Tigray, Ethiopia

Hailu¹

2018

J Preg Child Health

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Background: Ethiopia is one of the high fistula burdened countries in the world with an annual occurrence of 3,500 new and existence of 37,500 untreated obstetric fistula cases. Studies conducted in this area focus on determinants of obstetric fistula before surgical repair and researches addressing the associated factors are limited.Objective: To estimate time to recovery from a surgical repair of obstetric fistula and its associated factors among patients treated at Mekelle Hamlin Fistula Center. Results: The patients were followed for 6657 person days at risk, the median recovery time was 20 days. The overall recovery rate was 2.5 cases per 100 person days. Multivariable Cox proportional hazard model result showed labor duration of two or more days (AHR=0.73, 95% CI=0.53, 0.99) and post-operative bladder catheterization longer than 14 or more days (AHR=0.45, 95% CI=0.32, 0.62) were factors negatively associated with recovery time from obstetric fistula surgery. Methods Conclusion and recommendations:women who experienced labor of two or more days and post-operative bladder drainage for more than two or more weeks took longer time to recover after the repair. Therefore, Decision makers, Health care professionals, Stakeholders and Researchers should give emphasis on activities that reduce delays' in decision making, delays' in giving urgent intervention and delays' in reaching health institutions that contributes in reducing complications of prolonged labor ultimately obstetric fistula.Harmful traditional practices such as early marriage and home delivery are other potential factors for the development of obstetric fistula [8][9][10]. Globally, nine to 84% of obstetric fistula patients gave birth at home and more than 2 million women are currently living with this problem. Additional 50,000 to 100,000 new cases are estimated to occur each year and majority of which are from Africa and Asia [9][10][11][12][13].Incidence rates of obstetric fistula in countries with high maternal mortality is as high as two to three cases per 1000 women [14]. Estimated incidence and prevalence of untreated obstetric fistula in Ethiopia during the year 2010 was 3,500 and 37,500, respectively [9,15]. Introduction BackgroundObstetric fistula is an injury that occurs during prolonged or obstructed labor causing tissue damage to organs inside the pelvis and resulting in incontinence of urine, feces or both. The dead tissues due to prolonged pressure fall away and a hole will be formed between the vagina and bladder called Vesico-vaginal Fistula (VVF) or between the vagina and rectum called Recto Vaginal Fistula (RVF) [1][2][3].Obstetric fistula is the worst child birth related complication that contributes for 2.5% of the Global daily death of mothers associated with child birth related complications [4].The main causes of obstetric fistula in the developed world are radiation therapy and surgery whereas in developing countries, "the three delays" are responsible, the delay in seeking skilled emergency obstetric care, the del...

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The immediate management of fresh obstetric fistulas

Cited by 134 publications

References 3 publications

Vesicovaginal fistula: Do the patients know the cause?

Vesicovaginal fistula: Do the patients know the cause?

Retrospective Study of Obstetric Fistula among Clients Admitted To Fistula Unit Jimma University Specialized Hospital, Oromia Region, South West Ethiopia

Predictors of Time to Recovery from a Surgical Repair of Obstetric Fistula at Mekelle Hamlin Fistula Center, Tigray, Ethiopia

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