Evidence map›Paper›PMID 40247318›Full record

ArticleBMC surgery2025

Surgical success in obstetric fistula repair and associated factors: findings from a retrospective cohort study in Zambia.

Sianga Mutola, Bwalya Magawa Chomba, Nawi Ng, Dhally M Menda, Valérie R Louis, Lowery Wilson Michael

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Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Sianga MutolaFaculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany. sianga.mutola@uni-heidelberg.de.
Bwalya Magawa ChombaFistula Foundation Treatment Network in Zambia, Plot 001 Samfya Road, Mansa, Zambia.
Nawi NgSchool of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.
Dhally M MendaSchool of Postgraduate Studies, University of Lusaka, Lusaka, Zambia.
Valérie R LouisFaculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.
Lowery Wilson MichaelInjury Epidemiology and Prevention (IEP) Research Group, Turku University Hospital and University of Turku, Turku, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObstetric fistulas are common in low-resourced settings, but the factors associated with successful repair remain unclear in Zambia. We assessed the socio-demographics, fistula characteristics, and healthcare factors associated with successful obstetric fistula repair outcomes in Zambia.

methodsOur retrospective cohort study was based on the Zambia Fistula Foundation Treatment Network's clinical database, including 1439 women who underwent obstetric fistula surgical repairs at hospitals in Zambia between 2017 and 2023. Tanahashi's Health Services Coverage framework guided the selection of potential factors associated with successful obstetric fistula repair outcomes. We employed Multivariate Imputation by Chained Equations (MICE) before conducting logistic regression analyses. Univariable models, a multivariable model, and marginal probabilities were then fitted to examine the associations between successful obstetric fistula repair outcome, a fistula that is closed and dry, and relevant covariates.

resultsOur results showed an overall fistula repair success rate of 88.1%. Patients from the Northern and Muchinga provinces showed 51% (AOR = 0.49, 95% CI = 0.27, 0.90) lower odds of surgical repair success compared to those from Central and Lusaka provinces. Patients with a previous fistula repair had 47% lower odds of success (AOR = 0.53, 95% CI = 0.32, 0.87) than those without. Finally, surgeries rated intermediate in difficulty had 64% (AOR = 0.36, 95% CI = 0.18, 0.70), and those rated difficult had 90% (AOR = 0.10, 95% CI = 0.05, 0.21) lower odds of success than simple repairs.

conclusionWe identified geographic location, previous repair history, and surgical complexity as the factors associated with successful obstetric fistula repair outcomes.

Indexed as

Obstetric Labor ComplicationsVesicovaginal FistulaAdultFemaleHumansPregnancyRetrospective StudiesTreatment OutcomeYoung AdultZambiaFistula repairObstetric careObstetric fistulaSurgeryZambia

Identifiers

PMID40247318
PMCPMC12004560

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