Clinical procedures and practices used in the perioperative treatment of female genital fistula during a prospective cohort study

BMC Pregnancy and Childbirth

Mark A Barone^1,10  Abba Wali³  Dulal Chandra Podder⁵  Felicity Mussell⁶  Maura Lynch⁶  Maman Inoussa²  Sa’ad Idris^1,11  Sanda Oumarou Ganda¹  Dantani Danladi⁸  Abubakar Bello³  Thierno Hamidou Barry⁷  Frank Asiimwe⁹  Muhammad Bashir Abdullahi⁴  Veronica Frajzyngier^1,10  Joseph K Ruminjo^1,10 

[1] Lamorde Hospital, Niamey, Niger;Kitovu Mission Hospital, Kampala, Masaka, Uganda;Maryam Abacha Hospital, Sokoto, Sokoto State, Nigeria;Faridat Yakubu Hospital, Gusau, Zamfara State, Nigeria;Kumudini Hospital, Narayanganj, Bangladesh;LAMB Hospital, Rangpur Division, Parbatipur, Bangladesh;Prefectoral Hospital of Kissidougou, Kissidougou, Guinea;Specialist Fistula Centre Birnin Kebbi, Birnin Kebbi, Kebbi State, Nigeria;Kagando Hospital, Kagando, Kasese District, Uganda;EngenderHealth, 440 9th Avenue, FL 13, New York, NY 10001, USA;Maradi Hospital, Maradi, Niger

关键词: Fistula treatment;    Perioperative procedures;    Clinical practices;    Fistula repair;    Female genital fistula;   

Others  :  840673
DOI  :  10.1186/1471-2393-14-220

 received in 2013-11-07, accepted in 2014-06-27,  发布年份 2014

【 摘 要 】

Background

Treatment and care for female genital fistula have become increasingly available over the last decade in countries across Africa and South Asia. Before the International Federation of Gynaecology and Obstetrics (FIGO) and partners published a global fistula training manual in 2011 there was no internationally recognized, standardized training curriculum, including perioperative care. The community of fistula care practitioners and advocates lacks data about the prevalence of various perioperative clinical procedures and practices and their potential programmatic implications are lacking.

Methods

Data presented here are from a prospective cohort study conducted between September 2007 and September 2010 at 11 fistula repair facilities supported by Fistula Care in five countries. Clinical procedures and practices used in the routine perioperative management of over 1300 women are described.

Results

More than two dozen clinical procedures and practices were tabulated. Some of them were commonly used at all sites (e.g., vaginal route of repair, 95.3% of cases); others were rare (e.g., flaps/grafts, 3.4%) or varied widely depending on site (e.g. for women with urinary fistula, the inter-quartile range for median duration of post-repair bladder catheterization was 14 to 29 days).

Conclusions

These findings show a wide range of clinical procedures and practices with different program implications for safety, efficacy, and cost-effectiveness. The variability indicates the need for further research so as to strengthen the evidence base for fistula treatment in developing countries.

【 授权许可】

   
2014 Ruminjo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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