Good clinical outcomes from a 7-year holistic programme of fistula repair in Guinea
This article presents the clinical outcomes of 7 years of work involving 2116 women in 3 hospitals
Abstract
Objectives
Female genital fistula remains a public health concern in developing countries. From January 2007 to September 2013, the Fistula Care project, managed by EngenderHealth in partnership with the Ministry of Health and supported by USAID, integrated fistula repair services in the maternity wards of general hospitals in Guinea. The objective of this article was to present and discuss the clinical outcomes of 7 years of work involving 2116 women repaired in 3 hospitals across the country.
Methods
This was a retrospective cohort study using data abstracted from medical records for fistula repairs conducted from 2007 to 2013. The study data were reviewed during the period April to August 2014.
Results
The majority of the 2116 women who underwent surgical repair had vesicovaginal fistula (n = 2045, 97%) and 3% had rectovaginal fistula or a combination of both. Overall 1748 (83%) had a closed fistula and were continent of urine immediately after surgery. At discharge, 1795 women (85%) had a closed fistula and 1680 (79%) were dry, meaning they no longer leaked urine and/or faeces. One hundred and fifteen (5%) remained with residual incontinence despite fistula closure. Follow-up at 3 months was completed by 1663 (79%) women of whom 1405 (84.5%) had their fistula closed and 80% were continent.
Conclusion
Routine programmatic repair for obstetric fistula in low resources settings can yield good outcomes. However, more efforts are needed to address loss to follow-up, sustain the results and prevent the occurrence and/or recurrence of fistula.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
Alexandre Delamou, Moustapha Diallo, Abdoul Habib Beavogui, Ther ese Delvaux, Sita Millimono, Mamady Kourouma, Karen Beattie, Mark Barone, Thierno Hamidou Barry, Mohamed Khogali, Mary Edginton, Sven Gudmund Hinderaker, Joseph Ruminjo, Wei-Hong Zhang, Vincent De Brouwere (2015) Good clinical outcomes from a 7-year holistic programme of fistula repair in Guinea. Tropical Medicine and International Health volume 20 no 6 pp 813–819 doi:10.1111/tmi.12489
Links
Good clinical outcomes from a 7-year holistic programme of fistula repair in Guinea