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Women may experience severe urinary incontinence even after fistula closure

Written By : Medical Dialogues Editorial Team |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-04-08T09:00:00+05:30  |  Updated On 8 April 2022 8:45 PM IST
Erbium-YAG Laser to treat Female Stress Urinary Incontinence
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USA: In spite of successful fistula closure, women with obstetric fistulas experience significant chronic urine incontinence, says an article published in the American Journal of Obstetrics and Gynecology, on 10th March 2022.

Obstetric fistula is a potentially fatal birth injury. Despite effective fistula closure, 16-55% of women experience recurrent urine incontinence following surgery. R Nardos and colleagues investigated the kind and severity of persistent incontinence following successful fistula closure, as well as its influence on the quality of life of Ugandan women having obstetric fistula surgery, in this research.

Women having a history of obstetric fistula repair who continued to have persistent urine incontinence (cases, N=36) and women without incontinence (controls, N=52) were included in this cross-sectional research. Between 2017 and 2019, data were gathered in central and eastern Uganda. A semi-structured questionnaire was completed by all participants. Cases were evaluated clinically, subjected to a 2-hour pad test, and completed a battery of incontinence questionnaires, including two innovative measures developed to assess incontinence severity in low-literacy groups.

The results of this study stated as follow:

1. Cases were more likely to have had a fistula after their first birth, to have been younger when they got a fistula, and to have had more than two fistula procedures.

2. Cases reported a considerably greater rate of intended home births during their index pregnancy than controls, despite the fact that only 14% of cases and 12% of controls delivered at home.

3. Cases reported increased rates of discomfort during intercourse, but there was no significant difference in recent sexual activity status across the groups.

4. 67% of patients had stress incontinence, 47% had urgency incontinence, and 47% had mixed incontinence.

5. The cough stress test was performed effectively in 92 percent of the patients, and virtually all (97%) of these instances had a positive cough stress test.

6. More over half (53 percent) of those polled evaluated their incontinence as "very serious," which corresponded to objective findings.

7. The 24-hour voiding diary revealed both a high urine frequency (14 on average) and a high number of leaking events (average 20).

8. Two-hour pad testing revealed that 86% of patients saw a >4 gram change in pad weight within two hours.

9. Women who suffered from more severe incontinence had a greater negative impact on their quality of life. The mean ICIQ-QoL score was 62.77 12.76, with a higher score suggesting a stronger influence on the quality of life. Both patients and controls reported significant rates of suicidal thoughts at any stage since acquiring fistula.

In conclusion, according to the findings of the study, women with obstetric fistulas continue to have urine incontinence despite effective surgical closure. The intensity of incontinence is connected with a decline in quality of life. More study on surgical closure approaches and incontinence management in this population is required.

Reference:

Nardos, R., Jacobson, L., Garg, B., Wall, L. L., Emasu, A., & Ruder, B. (2022). Characterizing Persistent Urinary Incontinence After Successful Fistula Closure: The Uganda Experience. In American Journal of Obstetrics and Gynecology. Elsevier BV. https://doi.org/10.1016/j.ajog.2022.03.008


Urinary incontinencefistula surgeryAmerican Journal of Obstetrics and Gynecologyobstetric fistula
Source : American Journal of Obstetrics and Gynecology
Medical Dialogues Editorial Team
Medical Dialogues Editorial Team

    Medical Dialogues consists of a team of passionate medical/scientific writers, led by doctors and healthcare researchers. Our team efforts to bring you updated and timely news about the important happenings of the medical and healthcare sector. Our editorial team can be reached at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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