Prognostic factors and long-term outcomes of obstetric fistula care using the Tanguiéta model

Int J Gynaecol Obstet. 2020 Mar;148(3):331-337. doi: 10.1002/ijgo.13071. Epub 2020 Jan 24.

Abstract

Objectives: To identify factors influencing the long-term prognosis after surgical repair of obstetric fistula, establish a prognosis-based classification system, and examine changes in quality of life after surgery.

Methods: A retrospective study of 308 women who underwent obstetric fistula repair at Saint Jean de Dieu Hospital, Tanguiéta, Benin, between 2008 and 2016, and were supported by a multidisciplinary management model. All participants were from rural areas of Burkina Faso. The women completed interviews before, immediately after, and 2, 4-6, and 12 months after surgery to assess their clinical state and socioeconomic and psychologic status.

Results: Overall, the fistulae of 230/274 (83.9%) women were considered to be repaired after 12 months. Factors associated with poor repair outcome included the presence of sclerotic tissue (odds ratio [OR], 0.25; 95% confidence interval [CI], 0.11-0.53) and intraoperative complications (OR, 0.16; 95% CI, 0.07-0.39). Women with successful surgery had a better quality of life as compared with women with an unrepaired fistula (Ditrovie score, 1.1 vs 3.9; P<0.001).

Conclusion: The multidisciplinary Tanguiéta model for management of obstetric fistula allowed successful fistula closure, thereby facilitating the women's long-term social reintegration, and improved quality of life.

Keywords: Benin; Long-term obstetric fistula repair outcome; Obstetric fistula; Prognostic factors; Quality of life after obstetric fistula repair; Social reintegration; Tanguiéta model.

MeSH terms

  • Adult
  • Burkina Faso
  • Female
  • Humans
  • Middle Aged
  • Pregnancy
  • Quality of Life*
  • Retrospective Studies
  • Treatment Outcome
  • Vesicovaginal Fistula / psychology
  • Vesicovaginal Fistula / surgery*

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