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Good clinical outcomes from a 7‐year holistic programme of fistula repair in Guinea
Author(s) -
Delamou Alexandre,
Diallo Moustapha,
Beavogui Abdoul Habib,
Delvaux Thérèse,
Millimono Sita,
Kourouma Mamady,
Beattie Karen,
Barone Mark,
Barry Thierno Hamidou,
Khogali Mohamed,
Edginton Mary,
Hinderaker Sven Gudmund,
Ruminjo Joseph,
Zhang WeiHong,
De Brouwere Vincent
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12489
Subject(s) - medicine , fistula , vesicovaginal fistula , rectovaginal fistula , retrospective cohort study , surgery , general surgery
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 three 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. Twenty‐one per cent were lost to follow‐up. 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.