Treatment outcomes of obstetrical fistula surgical repair in low- and middle-income countries: A scoping review.

Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

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Affiliated Institutions:  College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia. School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia. College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Abstract summary 

Obstetrical fistula is an abnormal opening between the reproductive tract and lower urinary and/or gastrointestinal tract resulting from obstetrical complications, affecting nearly two million women worldwide. It imposes physical, economic, social, and mental consequences on the affected women. Treatment outcomes vary and, mostly, surgical treatment results in improved quality of life and successful subsequent pregnancy for survivors.The review aimed to chart and examine the treatment outcomes of obstetrical fistula surgical repair in low- and middle-income countries.This is a scoping review study to identify treatment outcomes of obstetrical fistula surgical repair in low- and middle-income countries. The search was conducted from databases (PUBMED, Embase, CINAHL, Scopus, and Web of Science), and gray literature (Google Scholar, Google, and conference proceedings).The eligibility criteria were constructed using a participant, concept, and context framework and included study types of primary research, reviews, and reports. Studies without full text and in languages other than English were excluded.The relevant characteristics of the included studies were extracted on an Excel spreadsheet and analyzed to chart treatment outcomes.The review examined the full text of 57 studies on the treatment outcomes of obstetrical fistula. The findings were grouped into two themes: early and late outcomes. The early outcomes included incontinence, surgical-site infection, urine retention, hemorrhage, and retained catheter. The late outcomes included fistula recurrence, residual incontinence, quality of life, reproductive issues, mental health, family and social support, and financial status.The treatment outcomes of obstetrical fistula can be grouped into short-term and long-term outcomes. Although this review found adequate studies for the analysis, most study designs were poor. Stronger studies are recommended in the future to guide policy and decision-making. We would like to suggest that researchers conduct systematic reviews and meta-analyses independently for short-term and long-term outcomes.

Authors & Co-authors:  Zeleke Liknaw Bewket LB Welsh Alec A Abeje Gedefaw G Khajehei Marjan M

Study Outcome 

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Statistics
Citations :  Chen CCG, Génadry R. Obstetric Fistula. Oxford Research Encyclopedia of Global Public Health; 2020.
Authors :  4
Identifiers
Doi : 10.1002/ijgo.15724
SSN : 1879-3479
Study Population
Female,Women
Mesh Terms
Other Terms
fistula;low‐income;middle‐income;obstetrical;scoping review;treatment outcomes
Study Design
Study Approach
Systemic Review
Country of Study
Publication Country
United States