Department of Midwifery, College of Health Science, Mattu University, P. O. Box 318, Mattu, Ethiopia.
Department of Midwifery, College of Medicine and Health Science, Mizan Tepi University, Mizan Tefere, Ethiopia.
BMC Womens Health. 2024 Mar 7;24(1):164. doi: 10.1186/s12905-024-02979-3.
Urinary incontinence (UI) after successful closure of obstetric vesicovaginal fistula (VVF) repair is a widely recognized public health problem. However, there is insufficient research evaluating the factors associated with UI after successful obstetric VVF repair in Ethiopia.
The main aim of this study was to assess the magnitude and associated factors of UI following the successful closure of obstetric VVF repair at the Yirgalem Hamlin Fistula Center in the Sidama region of southern Ethiopia.
A retrospective cross-sectional analytical study was performed on patients who underwent obstetric VVF repair at the Yirgalem Hamlin Fistula Center between 2016 and 2020. The data were collected from September to October 2021. EPI Data Version 3.1 and SPSS Version 25.0 were used for data entry and analysis. A multivariable binary logistic regression model was used for all variables significant in the bivariate binary logistic analysis to determine the association between the independent variables and outcome variables. The data are presented in tables and figures. Variables with a p-value < 0.05 were considered to be statistically associated with the study outcome.
In total, 499 study subjects were included. The magnitude of UI after successful closure of obstetric VVF repair was 23.25%. A Goh type 4 fistula (AOR = 4.289; 95% CI 1.431, 12.852), a fistula size > 3 cm (AOR = 8.855; 95% CI 4.786, 16.382), a partially damaged urethra (AOR = 2.810; 95% CI 1.441, 5.479), and a completely destroyed urethra (AOR = 5.829; 95% CI 2.094, 16.228) were found to be significantly associated factors with the outcome variable.
Nearly one in four patients who had successful closure of obstetric VVF repair at the Yirgalem Hamlin fistula center had UI, which is above the WHO recommendations. The presence of a Goh type 4 fistula, large fistula size, and damaged urethral status significantly affect the presence of UI. Therefore, interventions are necessary to prevent and manage UI among patients who underwent obstetric VVF repair and had a closed fistula.
产后成功修复膀胱阴道瘘（VVF）后发生尿失禁（UI）是一个广泛存在的公共卫生问题。然而，在埃塞俄比亚，对于产后 VVF 修复成功后发生 UI 的相关因素，研究还不够充分。
本研究的主要目的是评估在埃塞俄比亚南部锡达马地区的耶伊加勒姆·哈林瘘管中心成功修复产科 VVF 后 UI 的发生情况及其相关因素。
对 2016 年至 2020 年期间在耶伊加勒姆·哈林瘘管中心接受产科 VVF 修复的患者进行了回顾性横断面分析研究。数据收集于 2021 年 9 月至 10 月进行。EPI Data 版本 3.1 和 SPSS 版本 25.0 用于数据录入和分析。采用多变量二项逻辑回归模型对二项逻辑分析中具有统计学意义的所有变量进行分析，以确定独立变量与结果变量之间的关联。数据以表格和图形的形式呈现。具有 p 值<0.05 的变量被认为与研究结果具有统计学关联。
共纳入 499 例研究对象。产后 VVF 成功修复后发生 UI 的比例为 23.25%。Goh 4 型瘘管（AOR=4.289；95%CI 1.431，12.852）、瘘管直径>3cm（AOR=8.855；95%CI 4.786，16.382）、部分受损尿道（AOR=2.810；95%CI 1.441，5.479）和完全破坏的尿道（AOR=5.829；95%CI 2.094，16.228）与结果变量显著相关。
在耶伊加勒姆·哈林瘘管中心接受产科 VVF 成功修复的患者中，近四分之一的患者出现 UI，高于世卫组织的建议。Goh 4 型瘘管、大瘘管直径和受损尿道状态的存在显著影响 UI 的发生。因此，有必要对接受产科 VVF 修复且瘘管已闭合的患者进行 UI 的预防和管理干预。
