scholarly journals Outcome of urethral reconstruction among vesico-vaginal fistula patients: a cross-sectional study

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Olatunji O. Lawal ◽  
Rukiyat Adeola Abdus-salam ◽  
Oluwasomidoyin O. Bello ◽  
Imran O. Morhason-Bello ◽  
Oladosu A. Ojengbede
Keyword(s):  
Stress Incontinence ◽  
Obstetric Fistula ◽  
Cross Sectional Study ◽  
Successful Outcome ◽  
Urinary Continence ◽  
Urethral Reconstruction ◽  
Vaginal Fistula ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vesico Vaginal Fistula

Abstract Background Obstetric fistula (OF) complicated by urethral loss (UL) poses a challenge to both the fistula surgeon and obstetric fistula patient. The involvement of the urethra and urethral closure mechanism in OF is an important determinant of successful closure of fistula and restoration of urinary continence. OF with UL is often associated with unsuccessful repair outcome. We describe urethral reconstruction in genital tract fistula patients with UL and the outcomes of the repair. Methods Aim To review the clinical characteristics and outcome of vesico-vaginal fistula associated urethral loss following urethral reconstruction. This was a descriptive cross-sectional study conducted at the University College Hospital, Ibadan, Nigeria. A 5-year prospective data of all vesico-vaginal fistula patients with urethral loss (2011–2016) were reviewed and analysed. Data collected include socio-demographic and obstetric characteristics; cause of the fistula; and fistula characteristics—type of fistula, number of previous repairs, urethral loss, outcome of repair and follow-up. Data were entered and analysed using IBM SPSS version 20. Results Urethral loss occurred in 23 (15.3%) out of 150 women with OF; these women had urethral reconstruction surgery. The commonest type of urethral loss encountered in this cohort was proximal urethral loss which was seen in 12 (52.2%) patients. The most common types of fistula seen with urethral loss were large vesico-vaginal fistula (34.8%) and mid-vaginal fistula (26.1%). More than half of the women (56.6%) had previous unsuccessful repair at other facilities before presentation. The fistula closure rate was high (82.6%) regardless of type of urethral loss. Among the women with successful closure of OF with UL, about 36.8% had urinary stress incontinence post-fistula repair. Conclusion Urethral loss appears to be a rare complication of obstetric fistula. Successful closure with stress incontinence was seen in a sizeable number of women with OF with UL. Preoperative assessment for determinant of post-repair incontinence and surgical repair by experienced surgeons will improve successful outcome of repair in women with obstetric fistula with UL.

scholarly journals Surgical Outcome of Hundred Vesico Vaginal Fistula Patients in National Fistula Centre

2019 ◽  
Vol 48 (1) ◽  
pp. 39-43
Author(s):  
Shamima Akhter ◽  
Mst Mahbuba ◽  
Nusrat Ara Yusuf ◽  
Munirunnessa ◽  
Nasrin Rosy
Keyword(s):  
Surgical Outcome ◽  
Obstetric Fistula ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Easy Access ◽  
Vaginal Fistula ◽  
Cross Sectional ◽  
Splitting Technique ◽  
Operative Care ◽  
Vesico Vaginal Fistula

Vesico-vaginal fistula (VVF) is still a major global health problem.This study was performed to detect the surgical outcome of 100 VVF patients in National Fistula Centre. A descriptive cross sectional study was carried out among 100 VVF patients fulfilling the inclusion criteria admitted in the National Fistula Centre under the department of Obstetrics and Gynaecology during the study period of April, 2017 to September, 2017. During the period, 100 patients presented for surgical repair at a mean age of 28.7 years (SD7.1). Majority of them (49%) had a parity of one and 57% were less than 20 years old at the time of their first pregnancy. About 83% of women developed VVF following prolonged obstructed labour. Most of the fistula (95%) repaired through vaginal route by flap splitting technique and 73% repaired at 1st time. Recovery of most of the patient (75%) was uneventful. Inadequate post-operative care (26.9%) was the major causes of unsuccessful repair. Obstetric fistula is one of the tragedies of third world countries and it would be better solved by providing surgical procedure and easy access of all women to competent obstetrical care, irrespective of their social and economic  status during pregnancy and delivery. Bangladesh Med J. 2019 Jan; 48 (1): 39-43

scholarly journals Profile of Obstetric and Iatrogenic Fistula Surgeries at Kathmandu Model Hospital

2018 ◽  
Vol 13 (2) ◽  
pp. 19-22
Author(s):  
Ranjana Shrestha ◽  
Aruna Karki ◽  
Ganesh Dangal ◽  
Hema Pradhan ◽  
Kabin Bhattachan ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Obstetric Fistula ◽  
Sexual Life ◽  
Successful Outcome ◽  
Urinary Continence ◽  
Vaginal Fistula ◽  
Fistula Repair ◽  
Fistula Surgery ◽  
Prolonged Labor ◽  
Vesico Vaginal Fistula

Aims: Vesico-vaginal fistula (VVF) is an abnormal fistulous communication between the bladder and/or urethra and the vagina that allows continuous involuntary discharge of urine into the vaginal vault affecting patients’ medical, physical, mental, social and sexual life. The aim of this study was to review and deliver a profile, their demography and outcome in the early phase of fistula surgery performed in our institute. Methods: This was a retrospective study of 222 patients who underwent fistula surgery during the period of January 2012 to March 2018 in Kathmandu Model Hospital. The fistula were classified according to Goh`s system.  Patients’ demography, obstetric characteristics and fistula repair outcomes were reviewed. The primary outcome was in terms of urinary continence. Results: A total of 222 women aged between 10 to 65 years with a mean age of 31.4 were included. Majority of the patients had fistula due to obstetrical cause, contributing 58% (n=127) and in 42 % (n=95) of patients had fistula of gynecological etiology. Most of the patients had fistula of type 1a, contributing 38% (n=84) and only 0.01% (n=3) of type 3c and 4b according to Goh’s classification. Among 127 fistulas repaired of obstetric etiology100 (78.7%) patients and 85 (89.4%) out of 95 fistula patients of gynecological cause were continent and dry. Conclusions:  Our study showed obstructed and prolonged labor was the major cause of obstetric fistula, however iatrogenic fistula was also becoming common. Majority of our cases had successful outcome with some degree of stress in some patients.

scholarly journals Prevalence of Urinary Incontinence in Women

2020 ◽  
Vol 33 (1) ◽  
pp. 59-62
Author(s):  
Lubna Yasmin ◽  
Ferdousi Begum
Keyword(s):  
Urinary Incontinence ◽  
Stress Incontinence ◽  
Urge Incontinence ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mixed Incontinence ◽  
Medical College

Objective: The objectives of the study were to find out the prevalence of urinary incontinencein women. Materials and Methods: A cross sectional study was conducted on five hundred one (501)women older than 18 years of age who were admitted in department of obstetrics andgynaecology of Shaheed Suhrawardi Medical College and Hospital from April to December2009, answered a questionnaire about urinary incontinence. They were grouped accordingto presence or absence of urinary incontinence (incontinent and continent) and type ofincontinence present (urge, stress and mixed). Results: Urinary incontinence was found in 104(20.8%) women, out of which 25 (24%)suffered from stress incontinence only, 21 (20.2%) suffered from urge incontinence and58(55.8%) suffered mixed incontinence. Conclusions: One in five women older than 18 years of age suffer from one or other formof urinary Incontinence. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 59-62

scholarly journals Knowledge of Obstetric Fistula Prevention amongst Young Women in Urban and Rural Burkina Faso: A Cross-Sectional Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e85921 ◽  
Author(s):  
Aduragbemi O. Banke-Thomas ◽  
Salam F. Kouraogo ◽  
Aboubacar Siribie ◽  
Henock B. Taddese ◽  
Judith E. Mueller
Keyword(s):  
Burkina Faso ◽  
Young Women ◽  
Obstetric Fistula ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Fistula Prevention

scholarly journals Quality of Life among Obstetric Fistula Patients at Kitovu Mission Hospital: A Health Facility-Based Cross-Sectional Study in Masaka District, Uganda

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Samuel Kakembo ◽  
Christine Atuhairwe ◽  
Ivan Mugisha Taremwa
Keyword(s):  
Quality Of Life ◽  
Qualitative Content Analysis ◽  
Obstetric Fistula ◽  
Cross Sectional Study ◽  
Personal Relationships ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mission Hospital ◽  
Self Confidence

Background. Obstetric fistula (OF) remains a silent neglected maternal challenge associated with devastating life consequences. Living with OF presents far-reaching physical, social, psychosocial, and emotional concerns, which negatively impact a woman’s quality of life. This study evaluated the quality of life among obstetric fistula patients in Masaka district, Uganda. Method. A cross-sectional study was conducted among 63 women diagnosed with OF at Kitovu Mission Hospital. Data were collected using a questionnaire, observation, in-depth interviews, and focus group discussions. Data were analyzed at univariate, bivariate, and multivariate levels, where the ordinal logistic regression model was applied. The qualitative data was transcribed and analyzed using qualitative content analysis. Results. Majority (87%) of the women diagnosed with OF reportedly had a poor quality of life. Bivariate analysis indicated that level of education (P<0.001), employment status (P<0.001), energy for everyday life (P<0.001), capacity to work (P<0.001), satisfaction with personal relationships (P<0.001), feelings of loneliness (P<0.001), negative feelings (P=0.002), and self-confidence (P<0.001) were significantly associated with good QoL. Multivariate analysis showed increased odds of good QoL increased among women with self-confidence (OR = 32.320; CI = 2.019–517.467), formal education (OR = 9.9497; CI = 1.075–92.048), women who did not experience difficulties in mobility (OR = 19.144; CI = 0.149–2456.770), and women who were satisfied with their personal relationships (OR = 5.785; CI = 0.447–74.824). Conclusion. A holistic fistula treatment approach is required that takes into consideration all aspects of life to address the consequences of obstetric fistula to realize improved quality of life among patients.

scholarly journals Pelvic Ultrasound Findings in Women with Obstetric Fistula: A Cross-Sectional Study of Cases and Controls

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Jeffrey P. Wilkinson ◽  
Angela M. Bengtson ◽  
Ennet Chipungu ◽  
Rachel J. Pope ◽  
Bonus Makanani ◽  
...  
Keyword(s):  
Obstetric Fistula ◽  
Cross Sectional Study ◽  
Obstetric Outcomes ◽  
Sectional Study ◽  
Obstructed Labor ◽  
Partial Explanation ◽  
Cross Sectional ◽  
Endovaginal Ultrasound ◽  
Future Fertility ◽  
Cervical Stroma

Objective. Obstetric fistula (OF) is a morbid condition caused by prolonged obstructed labor. Women with OF experience profound injury and have high rates of infertility and poor obstetric outcomes. We examined endovaginal ultrasound parameters in women with and without OF. Design/Setting/Sample/Methods. This cross-sectional study enrolled women evaluated at the Fistula Care Centre in Lilongwe, Malawi. Eligibility criteria included age 18–45, prior pregnancy, and a uterus on ultrasound. Participants underwent endovaginal ultrasound with measurement of cervical dimensions. Comparisons were done using t-tests and Fisher's exact test. Among women with OF, linear regression was used to assess whether fistula stage was associated with cervical length. Results. We enrolled 98 cases and 12 controls. Women with OF had shorter cervical lengths (18.8 mm versus 27.3 mm, p < 0.01), as well as shorter anterior (7.0 mm versus 9.3 mm, p < 0.01) and posterior (9.5 mm versus 11.0 mm, p < 0.04) cervical stroma, compared to controls. Conclusion. Women with OF have shorter cervical lengths and anterior and posterior cervical stroma, when compared to women without OF. This may offer a partial explanation for subfertility and poor obstetric outcomes in OF patients. Additional studies to clarify the role of ultrasound in OF patients and prediction of future fertility are warranted.

Successful Outcome of Transfixation Technique with Linen in Dorsal Wrist Ganglion: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (243) ◽  
pp. 1150-1154
Author(s):  
Pralhad Thapa ◽  
Rajesh Bahadur Lakhey
Keyword(s):  
Patient Satisfaction ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Successful Outcome ◽  
Point Estimate ◽  
Outpatient Basis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Dorsal Wrist Ganglion

Introduction: Ganglion is a commonly encountered soft tissue tumor. Most commonly patients seek treatment for cosmetic issues. There are a variety of treatment options available but very few are effective and cosmetically acceptable. Common treatment techniques have either high recurrence rates or have complications. Treatment by transfixation with linen suture under local anaesthesia on an outpatient basis is an upcoming treatment. The objective of the study is to find out the prevalence of successful outcome of transfixation techniques in treatment of dorsal wrist ganglion. Methods: This study is a descriptive cross-sectional study undertaken at a tertiary care center from November 2018 to May 2020. Ethical approval was taken from the same institution. Convenient sampling method was used. Patients presenting with dorsal wrist ganglion and consenting for the transfixation underwent the procedure. All the patients were operated under local anesthesia. Statistical analysis was done using Statistical Package for Social Sciences version 24.0. Point estimate was done at 95% Confidence Interval and frequency and percentage were calculated. Results: Out of 30 cases, 29 (96.66%) have got successful outcomes with transfixation techniques. Among 30 patients, recurrences were seen in 2 (6.66%) cases. Patient satisfaction was high in 27 (90 %) cases. No complication was encountered. Conclusions: Transfixation technique had good results in terms of low recurrence rate, percentage resolution in size and high patient satisfaction.

scholarly journals Relying on Visiting Foreign Doctors for Fistula Repair: The Profile of Women Attending Fistula Repair Surgery in Somalia

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Abdi A. Gele ◽  
Abdulwahab M. Salad ◽  
Liban H. Jimale ◽  
Prabhjot Kour ◽  
Berit Austveg ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Obstetric Fistula ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Fistula Repair ◽  
Cross Sectional ◽  
One Year ◽  
Foreign Doctors ◽  
Study Participants ◽  
Obstetric Labor

Obstetric fistula is treatable by surgery, although access is usually limited, particularly in the context of conflict. This study examines the profile of women attending fistula repair surgery in three hospitals in Somalia. A cross-sectional study was conducted in Somalia from August to September 2016. Structured questionnaires were administered to 81 women who registered for fistula repair surgery in the Garowe, Daynile, and Kismayo General Hospitals in Somalia. Findings revealed that 70.4% of the study participants reported obstetric labor as the cause of their fistula, and 29.6% reported iatrogenic causes. Regarding the waiting time for the repair surgery, 45% waited for the surgery for over one year, while the rest received the surgery within a year. The study suggests that training for fistula surgery has to be provided for healthcare professionals in Somalia, fistula centers should be established, and access to these facilities has to be guaranteed for all patients who need these services.

scholarly journals Clinical profile of Female Urinary Incontinence: A Hospital Based Study

2021 ◽  
Vol 16 (1) ◽  
pp. 120-123
Author(s):  
Alka Shrestha
Keyword(s):  
Urinary Incontinence ◽  
Stress Incontinence ◽  
Associated Factors ◽  
Urge Urinary Incontinence ◽  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Mixed Urinary Incontinence ◽  
Female Urinary Incontinence ◽  
Sectional Study ◽  
Cross Sectional

Aim: To determine the prevalence of urinary incontinence of women attending gynae outdoor patient department. Method: It is a prospective cross sectional study conducted at Paropakar Maternity and Women’s Hospital for three months. Types of incontinence, their presentation, associated factors, age and parity were the variables studied. Data were analyzed by descriptive statistics. Results: Out of 950 gynaecological out-patients, 97 had urinary incontinence(10.2%); 34.1% were in 50- 59 years and 37.2% were multipara. Stressurinary incontinence (SUI) was the most common incontinence (56.7%) followed by mixed urinary incontinence (22.7%) and urge urinary incontinence (20.6%). Common complaints were leakage during coughing (63.6%) and sneezing(18.2%) in SUI;urgency and frequency were main problem in mixed and urge urinary incontinence. Three-fourth cases had associated medical conditions and rest had gynecological factors. Conclusions: Urinary incontinence is common in the fifth decade of life of women and more than half had stress incontinence.

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