RESUMEN
Obstetric fistula is estimated to affect 2 million women worldwide and has considerable social and psychological effects on affected individuals. In this prospective study, 51 consecutive women with obstetric fistula admitted to the Barhirdar Hamlin Fistula Centre in the north of Ethiopia were screened using the General Health Questionnaire (GHQ-28) for potential mental health disorder before and 2 weeks after fistula surgery. Prior to surgery, all women screened positive. By 2 weeks after, this had dropped to 36% (P = 0.005). 27% of the 45 women who were cured of their incontinence screened positive, while all 6 of those with severe residual incontinence continued to screen positive. We conclude that surgical treatment of obstetric fistula results in marked improvements in mental heath.
Asunto(s)
Trastornos Mentales/etiología , Complicaciones Posoperatorias/psicología , Fístula Vesicovaginal/cirugía , Adulto , Estudios de Cohortes , Femenino , Estado de Salud , Humanos , Salud Mental , Resultado del Tratamiento , Incontinencia Urinaria/psicología , Fístula Vesicovaginal/psicologíaRESUMEN
The aim of this study was to biomechanically assess vaginal tissue from pre- and postmenopausal women with symptomatic prolapse. Vaginal tissue was collected at the time of surgery in women with symptomatic prolapse. Tissue specimens were biomechanically assessed by a purpose-built tissue puller system and stress-strain curves were digitally recorded. Tissue was stretched at a constant rate of 0.8 mm/s to an elongation of 8 mm. A force-stiffness relationship was obtained. All data were normalized for length and cross-sectional area of the specimens. Tissues from the anterior vaginal wall were analyzed in 10 postmenopausal and 8 premenopausal women. The mean age of the postmenopausal women was 69 years, compared to 41 years for premenopausal women. Pre- and postmenopausal groups show very little or no difference regarding elongation or long-term tissue deformation. A significantly higher elastic modulus was observed in postmenopausal vaginal tissue. This is most likely an age-related phenomenon. Apart from this, pre- and postmenopausal vaginal tissue showed few differences in biomechanical assessment.