Factors associated with surgical repair success of female genital fistula in the Democratic Republic of Congo: Experiences of the Fistula Care Plus Project, 2017-2019.
Trop Med Int Health
; 27(9): 831-839, 2022 09.
Article
in En
| MEDLINE
| ID: mdl-35749231
ABSTRACT
OBJECTIVE:
We sought to document outcomes and factors associated with surgical success in hospitals supported by the Fistula Care Plus Project in the Democratic Republic of Congo (DRC), 2017-2019.METHODS:
This was a retrospective cohort study analysing routine repair data on women with Female Genital Fistula. Univariate and multivariate analyses were conducted to determine factors associated with successful fistula repair.RESULTS:
A total of 895 women were included in this study, with a mean age of 34 years (±13 years). The majority were married or in union (57.4%) and living in rural areas (82.0%), while nearly half were farmers (45.9%). The average duration living with fistula was 8 years (±7). Vesicovaginal (70.5%) and complex (59.8%) fistulas were the most common fistula types. Caesarean section (34.7%), obstructed labour (27.0%) and prolonged labour (23.0%) were the main aetiologies, with the causal deliveries resulting in stillbirth in 88% of cases. The vaginal route (74.9%) was the primary route for surgical repair. The median duration of bladder catheterization after surgery was 14 days (interquartile range [IQR] 7-21). Multivariate analysis revealed that Waaldijk type I fistula (adjusted odds ratio [aOR]2.71, 95% confidence interval [CI]1.36-5.40), no previous surgery (aOR2.63, 95% CI1.43-3.19), repair at Panzi Hospital (aOR 2.71, 95% CI1.36-5.40), and bladder catheterization for less than 10 days (aOR13.94, 95% CI 4.91-39.55) or 11-14 days (aOR 6.07, 95% CI 2.21-15.31) were associated with better repair outcomes.CONCLUSION:
The Fistula Care Plus Project in the DRC recorded good fistula repair outcomes. However, further efforts are needed to promote adequate management of fistula cases.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Vesicovaginal Fistula
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Country/Region as subject:
Africa
Language:
En
Journal:
Trop Med Int Health
Journal subject:
MEDICINA TROPICAL
/
SAUDE PUBLICA
Year:
2022
Type:
Article
Affiliation country:
Democratic Republic of the Congo