Treatment Outcomes of Obstetrical Fistula Repair in Low-And Middle-Income Countries

Obstetrical fistula, an abnormal opening between the reproductive tract and the lower urinary or gastrointestinal tract, affects nearly two million women worldwide and leads to significant physical, social, economic, and psychological consequences. Surgical repair is the primary treatment, often improving the quality of life and enabling subsequent pregnancies. 

A study published in the International Journal of Gynecology & Obstetrics examined obstetrical fistula repair treatment outcomes in low- and middle-income countries by analyzing 57 studies from PUBMED, Embase, CINAHL, Scopus, Web of Science, and gray literature. 

Outcomes were categorized as early and late. Early outcomes included incontinence, surgical-site infection, urine retention, hemorrhage, and retained catheter, and late outcomes included fistula recurrence, residual incontinence, quality of life, reproductive health, mental well-being, social support, and financial status. The review revealed that most studies concentrated on the success of fistula closure and incontinence-related outcomes following surgical repair. While the review identified sufficient studies, many had poor designs, highlighting the need for more substantial research and independent systematic reviews and meta-analyses for short- and long-term outcomes.

Reference:

Zeleke LB, Welsh A, Abeje G, Khajehei M. Treatment outcomes of obstetrical fistula surgical repair in low‐and middle‐income countries: A scoping review. International Journal of Gynecology & Obstetrics. 2024 Nov;167(2):491-500.

https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.15724