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Successful surgical repair outcomes and determinants among obstetric fistula patients: A multi-centre study from
Liknaw Bewket Zeleke1, Alec Welsh2, Gedefaw Abeje3
1College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Insights
Surgical repair of obstetric fistula in Ethiopia achieved a 77.5% success rate. Factors like underweight BMI and longer fistula length were associated with lower success, highlighting the need for improved treatment strategies.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Surgical Repair Outcomes
Background:
- Obstetric fistula, a severe injury from prolonged obstructed labor, disproportionately affects women in developing nations.
- Surgical repair is common, but outcomes in Ethiopia are inconsistently reported.
- This study addresses the need for clear data on obstetric fistula repair success rates in Ethiopia.
Purpose of the Study:
- To evaluate the success rate of obstetric fistula surgical repair in Ethiopia.
- To identify factors associated with successful surgical repair outcomes.
Main Methods:
- A longitudinal cohort study was conducted with 386 women undergoing fistula repair across six Ethiopian centers.
- Data were collected via structured questionnaires and the Research Electronic Data Capture tool.
- Statistical analysis was performed using R software.
Main Results:
- A 77.5% success rate was observed for obstetric fistula surgical repair.
- Significant factors associated with successful repair included having an alive child, while underweight BMI, fistula length greater than 2 cm, and urethral damage were associated with lower success rates.
Conclusions:
- The overall success rate for obstetric fistula repair in Ethiopia is below WHO recommendations.
- There is a critical need for collaborative efforts to enhance treatment approaches and meet international standards.
Background:
Obstetric fistula is a life-altering form of complex obstetric injury caused by prolonged obstructed labour. It remains a significant public health concern in developing countries, particularly in regions across the northern half of sub-Saharan Africa and in parts of the Middle East and South Asia. Many women undergo surgery to repair their fistulas; however, there are inconsistent reports in the literature regarding surgical repair outcomes, particularly in Ethiopia.
Methods:
The study was undertaken at six treatment centres in Ethiopia using a longitudinal cohort design among 386 women with obstetric fistula. The participants underwent surgical repair of their fistula and were followed up until their outcome was determined. The data were collected using a structured questionnaire and an electronic data collection tool, Research Electronic Data Capture. The collected data were exported in various formats and analysed using R software.
Results:
The study revealed that 77.5 % of the participants achieved successful surgical repair. Underweight body mass index (BMI) (AOR: 0.68, 95 %CI = 0.252, 1.977), having an alive child (AOR: 3.19, 95 %CI = 1.089, 9.638), fistula length > 2 cm (AOR: 0.40, 95 %CI = 0.183, 0.851) and urethral damage (AOR: 0.41, 95 %CI = 0.221, 0.753) showed significant associations with successful surgical repair outcomes.
Conclusion:
While many obstetric fistula repairs are successful, the overall success rate in Ethiopia falls below the World Health Organization's recommendation. Collaborative efforts are needed to revise the treatment approaches to meet the World Health Organization's standards.
