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Factors associated with the failure of obstetric fistula repair in Guinea: implications for practice

机译：几内亚产科瘘修复失败的相关因素：对实践的启示

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Background The prevention and treatment of obstetric fistula still remains a concern and a challenge in low income countries. The objective of this study was to estimate the overall proportions of failure of fistula closure and incontinence among women undergoing repair for obstetric fistula in Guinea and identify its associated factors. Methods This was a retrospective cohort study using data extracted from medical records of fistula repairs between 1 January 2012 and 30 September 2013. The outcome was the failure of fistula closure and incontinence at hospital discharge evaluated by a dye test. A sub-sample of women with vesicovaginal fistula was used to identify the factors associated with these outcomes. Results Overall, 109 women out of 754 (14.5?%; 95?% CI:11.9–17.0) unsuccessful repaired fistula at discharge and 132 (17.5?%; 95 % CI:14.8–20.2) were not continent. Failure of fistula closure was associated with vaginal delivery (AOR: 1.9; 95?% CI: 1.0–3.6), partially (AOR: 2.0; 95?% CI: 1.1–5.6) or totally damaged urethra (AOR: 5.9; 95?% CI: 2.9–12.3) and surgical repair at Jean Paul II Hospital (AOR: 2.5; 95?% CI: 1.2–4.9). Women who had a partially damaged urethra (AOR: 2.5; 95?% CI: 1.5–4.4) or a totally damaged urethra (AOR: 6.3; 95?% CI: 3.0–13.0) were more likely to experience post-repair urinary incontinence than women who had their urethra intact. Conclusion At programmatic level in Guinea, caution should be paid to the repair of women who present with a damaged urethra and those who delivered vaginally as they carry greater risks of experiencing a failure of fistula closure and incontinence.
机译：背景技术在低收入国家，产科瘘的预防和治疗仍然是一个关注和挑战。这项研究的目的是估计几内亚进行产科瘘修复的女性中瘘管闭合失败和失禁的总体比例，并确定其相关因素。方法这是一项回顾性队列研究，使用从2012年1月1日至2013年9月30日进行的瘘管修复医学记录中提取的数据。结果是通过染料测试评估了瘘管闭合失败和尿失禁的情况。使用女性阴道阴道瘘的子样本来确定与这些结局相关的因素。结果总体而言，在出院时瘘管修复失败的754名女性中，有109名女性（14.5％; 95％CI：11.9-17.0）未成功，而132名女性（17.5％; 95％CI：14.8-20.2）不是大陆。瘘管闭合失败与阴道分娩有关（AOR：1.9; 95％CI：1.0–3.6），部分（AOR：2.0; 95％CI：1.1–5.6）或尿道完全受损（AOR：5.9; 95？ ％CI：2.9–12.3）和让·保罗二世医院的手术修复（AOR：2.5; 95％CI：1.2–4.9）。尿道部分受损（AOR：2.5; 95％CI：1.5–4.4）或尿道完全受损（AOR：6.3; 95％CI：3.0–13.0）的女性更有可能在手术后出现尿失禁比那些尿道完好的女性。结论在几内亚的计划层面上，应注意修复尿道受损的妇女和阴道分娩的妇女，因为这些妇女遭受瘘管闭合和大小便失禁的风险更大。

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