Azeze Gedion Asnake, Haile Kirubel Eshetu, Gebeyehu Natnael Atnafu, Kena Sintayehu Solomon, Tsegaye Tewodros Getachew, Gebrekidan Amanuel Yosef, Alelgn Yitateku, Kassie Gizachew Ambaw, Asgedom Yordanos Sisay
Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa city, Sidama Region, Ethiopia.
School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, P.O.Box: 138, Wolaita Sodo town, Southern Region, Ethiopia.
BMC Womens Health. 2025 Apr 8;25(1):165. doi: 10.1186/s12905-025-03701-7.
Obstetric vesico-vaginal fistula is a known complication that can occur following damage to the bladder wall during prolonged obstructed labor and operative delivery. Urinary incontinence following the repair of obstetric fistula remains a significant health problem and can greatly damage a women's ability to function confidently. There are approximately two million women suffering from urinary incontinence following obstetric fistula repair, most of whom are primarily in Africa.
We aimed to systematically review and conduct meta-analysis on the magnitude of urinary incontinence among women following successful obstetric fistula repair in sub-Saharan African countries.
We thoroughly searched online database including Medline, Scopus, Science Direct, Excerpta Medica Database, African Journals Online and Google Scholar for eligible articles from their inception to November 10, 2024. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 checklist. To generate pooled prevalence of urinary incontinence, we used random-effects model. The presence of publication bias was determined using a funnel plot and Egger's regression test.
Out of 1044 articles found following our initial search and after titles and abstracts review, we considered 277 full text articles for inclusion. Lastly, a total of 12 articles from five sub-Saharan African countries comprising 6,104 participants met the inclusion criteria for quantitative meta-analysis. The pooled prevalence of urinary incontinence following obstetric fistula repair was 16.32% (95%CI: 11.80, 20.84; I2 = 96.5%, P < 0.001).
Overall, our findings show post-fistula repair incontinence remains an important clinical problem. Therefore, we believe that policy planners and researchers of sub-Saharan African nations may use the findings of the current study for evidence based care planning and patient counseling strategy.
Registered in PROSPERO under protocol number CRD42023416541.
产科膀胱阴道瘘是一种已知的并发症，可在产程延长受阻和手术分娩期间膀胱壁受损后发生。产科瘘修补术后的尿失禁仍然是一个严重的健康问题，会极大损害女性自信生活的能力。约有200万女性在产科瘘修补术后患有尿失禁，其中大多数主要在非洲。
我们旨在系统评价并对撒哈拉以南非洲国家成功进行产科瘘修补术后女性尿失禁的严重程度进行荟萃分析。
我们全面检索了在线数据库，包括Medline、Scopus、Science Direct、医学文摘数据库、非洲在线期刊和谷歌学术，以查找从创刊至2024年11月10日的符合条件的文章。本系统评价遵循系统评价和荟萃分析的首选报告项目（PRISMA）2020清单。为得出尿失禁的合并患病率，我们使用随机效应模型。使用漏斗图和埃格回归检验确定是否存在发表偏倚。
在我们初步检索后找到的1044篇文章中，经标题和摘要审查后，我们考虑纳入277篇全文文章。最后，来自撒哈拉以南非洲五个国家的12篇文章共6104名参与者符合定量荟萃分析的纳入标准。产科瘘修补术后尿失禁的合并患病率为16.32%（95%CI：11.80，20.84；I2 = 96.5%，P < 0.001）。
总体而言，我们的研究结果表明瘘修补术后尿失禁仍然是一个重要的临床问题。因此，我们认为撒哈拉以南非洲国家的政策制定者和研究人员可将本研究结果用于循证护理规划和患者咨询策略。
在PROSPERO注册，注册号为CRD42023416541。
