ArticleBJOG : an international journal of obstetrics and gynaecology2017
Use of a postoperative pad test to identify continence status in women after obstetric vesicovaginal fistula repair: a prospective cohort study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- FIGO good practice recommendations to standardize the assessment of outcomes following vesicovaginal fistula surgery.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- Systematic review of the use of big data to improve surgery in low- and middle-income countries.The British journal of surgery · 2019Pooled it
- Predictors of outcomes in patients with repeat surgery for obstetric fistula: a retrospective review.International urogynecology journal · 2023Article
- The Microcirculation of Vaginal Tissue in Women with Obstetric Vesicovaginal Fistula and Short-Term Effects of Surgical Repair on Microvascular Parameters.Gynecologic and obstetric investigation · 2023Observational
- Effect of Paula exercise method on functional outcomes of women with post fistula repair incontinence: a protocol for randomized controlled trial.BMC women's health · 2021Article
- Characteristics of persistent urinary incontinence after successful fistula closure in Ethiopian women.International urogynecology journal · 2020Article
- A review of surgical procedures to repair obstetric fistula.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2020Article
- Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study.BJOG : an international journal of obstetrics and gynaecology · 2019Article
- State of the Art for Treatment of Vesicovaginal Fistula.Current urology reports · 2017Review
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6 authors at 3 institutions in 2 countries.
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Abstract
objectiveDetermine whether a 1-hour pad test at discharge can identify continence status within 120 days of obstetric vesicovaginal fistula (VVF) repair.
designProspective cohort study.
settingFistula Care Centre in Lilongwe, Malawi. POPULATION: Women with VVF who underwent repair between January 2012 and December 2014.
methodsData on demographics, obstetric history, physical exam findings, operative management, postoperative findings, and follow up evaluations were collected on women with VVF repair.
main outcome measuresSensitivity, specificity, positive and negative predictive values (PPV and NPV), and a receiver operating curve (ROC) were calculated to assess the utility of using a discharge pad test at three thresholds to identify women likely to be continent at follow up.
resultsAfter VVF repair, 346 women had a 1-hour pad test performed at the time of hospital discharge and completed follow up within 120 days of repair. Of these, 79.8% (n = 276) were completely continent, whereas 20.2% (n = 70) had some degree of incontinence. The sensitivity and specificity of a negative 1-hour pad test at predicting continence is 68.1% and 82.9%, respectively. With this prevalence, a negative pad test at a 1.5-g threshold demonstrates a high predictive value (PPV = 94.0%, 95% CI 90.0-96.9) in detecting women with continence after repair.
conclusionsAt the 1.5-g threshold, a negative pad test at discharge identifies 94% of women who will remain continent after VVF repair. Adding the pad test to fistula care can identify women who are likely to remain continent and may not need further therapies in settings where resources are limited and follow up after repair is difficult. TWEETABLE ABSTRACT: A negative pad test after repair is associated with continued continence at follow up.
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