From: Factors associated with the failure of obstetric fistula repair in Guinea: implications for practice
Variables | Failure of fistula closure (Yes) | Fistula incontinence (Yes) | ||||
---|---|---|---|---|---|---|
N (%) | Unadjusted OR [95 % CI] | Adjusteda,b OR [95 % CI] | N (%) | Unadjusted OR [95 % CI] | Adjusteda,c OR [95 % CI] | |
Mean age at presentation (SD), years | 38.9 (14.1) | 1.02 (1.00–1.04) | 1.02 (1.00–1.04) | 38.2 (13.6) | 1.02 (1.00–1.03) | 1.01 (0.99–1.03) |
Residence | ||||||
Rural | 81 (13.4) | 1 | - | 101 (16.7) | 1 | - |
Urban | 6 (14.0) | 1.0 (0.4–2.5) | 9 (20.9) | 1.3 (0.6–2.8) | ||
Marital status | ||||||
Married/Union | 55 (11.9) | 1 | 1 | 70 (15.2) | 1 | 1 |
Other (single, separated, widow) | 29 (16.9) | 1.5 (0.9–2.4) | 1.1 (0.6–1.9) | 36 (21.0) | 1.5 (0.9–2.3) | 1.2 (0.7–2.1) |
Occupation | ||||||
Housewife | 82 (13.4) | 1 | - | 104 (17.0) | 1 | - |
Worker | 3 (15.8) | 1.2 (0.3–4.2) | 4 (21.0) | 1.3 (0.4–4.0) | ||
Education | ||||||
None | 79 (13.3) | 1.0 (0.4–2.5) | - | 102 (17.2) | 1.4 (0.6–3.4) | - |
Primary and more | 6 (12.8) | 1 | 6 (12.8) | 1 | ||
Mean parity (SD), deliveries | 3.6 (2.8) | 0.97 (0.89–1.06) | - | 3.5 (2.8) | 0.95 (0.87–1.03) | 1.00 (0.90–1.11) |
Mean duration of labor (SD), years | 3.4 (1.6) | 1.10 (0.95–1.28) | - | 3.4 (1.5) | 1.08 (0.95–1.24) | - |
Mode of delivery | ||||||
Vaginal | 65 (15.7) | 2.3 (1.3–4.0) | 1.9 (1.0–3.6) | 80 (19.3) | 1.9 (1.1–3.0) | 1.5 (0.9–2.6) |
Caesarean section | 16 (7.6) | 1 | 1 | 24 (11.4) | 1 | 1 |
Neonatal outcome at delivery | ||||||
Alive | 2 (6.9) | 1 | - | 2 (6.9) | 1 | 1 |
Stillborn | 82 (13.6) | 2.1 (0.5–9.1) | 105 (17.5) | 2.9 (0.7–12.2) | 2.0 (0.4–9.1) | |
Vaginal scarring | ||||||
Yes | 56 (16.8) | 1.9 (1.1–2.9) | 1.2 (0.7–2.0) | 73 (21.9) | 2.0 (1.3–3.1) | 1.3 (0.7–2.1) |
No | 31 (10.1) | 1 | 1 | 37 (12.1) | 1 | 1 |
Status of the urethra | ||||||
Intact | 26 (7.6) | 1 | 1 | 32(9.4) | 1 | 1 |
Partially damaged | 34 (14.5) | 2.1 (1.2–3.5) | 2.0 (1.1–5.6) | 49 (20.9) | 2.6 (1.6–4.1) | 2.5 (1.5–4.4) |
Totally damaged | 27 (42.9) | 9.1 (4.8–17.3) | 5.9 (2.9–12.3) | 29 (46.0) | 8.3 (4.5–15.3) | 6.3 (3.0–13.0) |
Previous surgical repair | 0.83 (0.99) | 1.11 (0.90–1.38) | - | 0.92 (1.13) | 1.23 (1.02–1.48) | 1.04 (0.83–1.31) |
Year or repair | ||||||
2012 | 62 (15.2) | 1.5 (0.9–2.5) | 1.0 (0.6–1.8) | 78 (19.1) | 1.5 (1.0–2.4) | 1.0 (0.6–1.6) |
2013 | 25 (10.5) | 1 | 1 | 32 (13.4) | 1 | 1 |
Fistula related post-op complications | ||||||
No | 84 (13.2) | 1 | 1 | 107 (16.8) | 1 | - |
Yes | 3 (30.0) | 2.8 (0.7–11.1) | 2.9 (0.5–15.9) | 3 (30.0) | 2.8 (0.8–9.8) | |
Repair site | ||||||
Jean-Paul 2 Hospital | 33 (20.8) | 2.7 (1.5–4.7) | 2.5 (1.2–4.9) | 36 (22.6) | 1.6 (1.0–2.6) | 1.6 (0.8–3.1) |
Labe regional Hospital | 27 (14.8) | 1.8 (1.0–3.2) | 1.6 (0.9–3.0) | 27 (14.8) | 1.0 (0.6–1.6) | 0.8 (0.5–1.4) |
Kissidougou District Hospital | 27 (8.9) | 1 | 1 | 47 (15.4) | 1 | 1 |