Factors influencing urinary fistula repair outcomes in developing countries: a systematic review

We reviewed literature examining predictors of urinary fistula repair outcomes in developing country settings, including fistula and patient characteristics, and perioperative factors. We searched Medline for articles published between January 1970 and December 2010, excluding articles that were (1)...

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Bibliographic Details
Published inAmerican journal of obstetrics and gynecology Vol. 207; no. 4; pp. 248 - 258
Main Authors Frajzyngier, Vera, Ruminjo, Joseph, Barone, Mark A.
Format Journal Article
LanguageEnglish
Published New York, NY Mosby, Inc 01.10.2012
Elsevier
Subjects
Biological and medical sciences
Delivery of Health Care
Delivery. Postpartum. Lactation
Developing Countries
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
obstetric fistula
Obstetrics and Gynecology
surgical outcomes
systematic review
Treatment Outcome
Urinary Fistula - surgery
obstetric fistula
surgical outcomes
systematic review
developing countries
Urine
Prognosis
Gynecology
Developing countries
Fistula
Review
Obstetrics
Pregnancy
Treatment
Surgery
Delivery
Repair
Bibliographic review
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Summary:We reviewed literature examining predictors of urinary fistula repair outcomes in developing country settings, including fistula and patient characteristics, and perioperative factors. We searched Medline for articles published between January 1970 and December 2010, excluding articles that were (1) case reports, cases series or contained 20 or fewer subjects; (2) focused on fistula in developed countries; and (3) did not include a statistical analysis of the association between facility or individual-level factors and surgical outcomes. Twenty articles were included; 17 were observational studies. Surgical outcomes included fistula closure, residual incontinence after closure, and any incontinence (dry vs wet). Scarring and urethral involvement were associated with poor prognosis across all outcomes. Results from randomized controlled trials examining prophylactic antibiotic use and repair outcomes were inconclusive. Few observational studies examining perioperative interventions accounted for confounding by fistula severity. We conclude that a unified, standardized evidence-base for informing clinical practice is lacking.
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SourceType-Scholarly Journals-1
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ISSN:0002-9378
1097-6868
1097-6868
DOI:10.1016/j.ajog.2012.02.006