Effect of vaginal scarring on the recovery of surgical repair of obstetric fistula in Northern Ethiopia. Issue 3 (20th September 2022)

• Record Type: Journal Article
• Authors: Ambese, Tesfay Yohannes; Gebre, Hagazi; Berhe, Awtachew; Fisseha, Girmatsion; Gufue, Zenawi Hagos; Hailu, Nigus Alemu; Ebrahim, Mohamedawel Mohamednigus; Abraha, Hiluf Ebuy
• Is Part Of: International journal of gynaecology and obstetrics. Volume 160:Issue 3(2023)
• Page Start: 915
• Page End: 925
• Publication Date: 2022-09-20
• Subjects: Ethiopia -- obstetric fistula -- predictors of recovery -- vaginal scar; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.14425
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To determine the effect of vaginal scarring on the recovery from surgical repair of obstetric fistula in Northern Ethiopia from 2015 to 2020. Methods: A hospital‐based retrospective cohort study was conducted among 224 women who had obstetric fistula repair surgery in Northern Ethiopia from March 1 to March 31, 2020. Cox proportional hazards regression model was used to determine the adjusted predictors of recovery for each main baseline predictor variable, using 95% confidence interval (CI) and P < 0.05 to declare statistical significance. Results: The overall recovery rate was 57 of 1000 women (43 of 1000 and 73 of 1000 for women with and without vaginal scar, respectively), with an overall median time to recovery from obstetric fistula repair surgery of 15 days. Vaginal scarring (adjusted hazard ratio [aHR], 1.58 [95% CI, 1.13–2.21]), age of the patient (aHR, 4.05 [95% CI, 1.56–10.5]), mode of delivery (aHR, 2.14 [95% CI, 1.31–3.49]), place of delivery (aHR, 1.91 [95% CI, 1.17–3.12]), prior repair (aHR, 1.90 [95% CI, 1.08–3.35]), and duration of catheterization (aHR, 12.91 [95% CI, 7.21–23.13]) were independent predictors of recovery. Conclusions: In the present study, we found that women who had no vaginal scar, age older than 30 years, facility and spontaneous vaginal delivery, first attempt repair, and shorter duration of catheterization had a shorter recover time. Synopsis: Vaginal scarring is an important factor for predicting the time to recovery after surgical repair of obstetric fistula. This will guide health professionals and health policy makers to identify indicators for monitoring women with obstetric fistula and applying necessary preventive and appropriate measures to decrease time to recovery of patients.