Title: Prognostic factors and long‐term outcomes of obstetric fistula care using the Tanguiéta model
Author(s): Anne‐Caroline Benski, Martine Delavy, Charles‐Henry Rochat, Manuela Viviano, Rosa Catarino, Valérie Elsig, Abdoulaye Doulougou, Patrick Petignat, Pierre Vassilakos
Publication date: 28.11.2019
Link: https://doi.org/10.1002/ijgo.13071
Category : Research

The article aims 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.