Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study.
BJOG
; 126(7): 926-934, 2019 Jun.
Article
em En
| MEDLINE
| ID: mdl-30461170
ABSTRACT
OBJECTIVE:
We evaluated residual incontinence, depression, and quality of life among Malawian women who had undergone vesicovaginal fistula (VVF) repair 12 or more months previously.DESIGN:
Prospective cohort study.SETTING:
Fistula Care Centre in Lilongwe, Malawi. POPULATION Women who had undergone VVF repair in Lilongwe, Malawi at least 12 months prior to enrolment.METHODS:
Self-report of urinary leakage was used to evaluate for residual urinary incontinence; depression was evaluated with the Patient Health Questionnaire-9; quality of life was evaluated with the King's Health Questionnaire. MAIN OUTCOMEMEASURES:
Prevalence and predictors of residual incontinence, quality of life scores, and prevalence of depression and suicidal ideation.RESULTS:
Fifty-six women (19.3%) reported residual urinary incontinence. In multivariable analyses, predictors of residual urinary incontinence included pre-operative Goh type 3 [adjusted risk ratio (aRR) 2.82; 95% confidence interval (CI) 1.61-5.27) or Goh type 4 1.08-2.78), positive postoperative cough stress test (aRR = 2.42; 95% CI 1.24-4.71) and the positive 1-hour postoperative pad test (aRR = 2.20; 95% CI 1.08-4.48). Women with Goh types 3 and 4 VVF reported lower quality of life scores. Depressive symptoms were reported in 3.5% of women; all reported residual urinary incontinence.CONCLUSIONS:
While the majority of women reported improved outcomes in the years following surgical VVF repair, those with residual urinary incontinence had a poorer quality of life. Services are needed to identify and treat this at-risk group. TWEETABLE ABSTRACT Nearly one in five women reported residual urinary incontinence at follow up, 12 or months after vesicovaginal fistula repair.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações na Gravidez
/
Qualidade de Vida
/
Incontinência Urinária
/
Fístula Vesicovaginal
/
Transtorno Depressivo
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Middle aged
/
Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
BJOG
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Malauí