Obstetric fistula scoring tool for surgical trainees

Area of Science:

• Urology
• Gynecology
• Surgical Outcomes

Background:

• Vesicovaginal fistula (VVF) repair outcomes can be challenging to predict.
• Objective measures are needed to guide surgical decision-making and training.

Purpose of the Study:

• To validate a risk score for predicting incontinence at discharge in VVF patients.
• To assess the correlation between this risk score and surgical skill level.

Main Methods:

• Retrospective cohort study of 176 women undergoing vaginal VVF repair (Jan-June 2018).
• Analysis of operative records for factors predicting incontinence.
• Evaluation of risk score cut-point (≥20) against surgical skill.

Main Results:

• Factors like Goh classification, fistula size, and scarring predicted incontinence.
• A risk score ≥20 had 92% negative predictive value for residual incontinence.
• Higher-risk cases were disproportionately assigned to more experienced surgeons.

Conclusions:

• The risk score shows promise in predicting VVF repair outcomes and correlates with surgical skill.
• This objective tool may assist surgical trainees in patient management decisions.
• The score can help determine optimal surgical approach or referral for improved patient results.