Hospital-related factors associated with incontinence following vesicovaginal fistula repair at Bwaila fistula care centre

Abstract

Background/Aims Surgery remains the only reliable treatment option for vesicovaginal fistula; however, not all women who undergo surgical treatment regain continence. Information on predictors of vesicovaginal fistula closure outcomes is scarce and mostly limited to patient-related factors. This study examined hospital-related factors associated with incontinence in women following vesicovaginal fistula repair at the Bwaila fistula care centre in Malawi. Methods This quantitative retrospective cross-sectional study used simple random sampling to identify 174 case files of women who underwent vesicovaginal fistula repair. Data were analysed using binary and multivariable logistic regression to explore the effects of hospital-related variables on the likelihood of women remaining incontinent after obstetric fistula repair. Results The overall closure rate was 73.6%. Only number of days with a Foley catheter was found to predict incontinence after fistula repair at discharge from the hospital (P=0.013), in multivariate analysis. Conclusions Number of days with a catheter was the only significant predictor of incontinence after repair. Surgeons should consider reducing the number of days assigned with a catheter following surgery. Future studies should follow a prospective approach in settings where all variables can be effectively explored.