Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia

摘要

Obstetric fistula is an abnormal connection between the vagina and rectum and/or bladder, which leads to continuous urinary or fecal incontinence. It is a serious problem in the world poorest countries, where most mothers give birth without any medical care. In most cases obstetric fistula is preventable and can be treated successfully, if it is carried out by a competent surgeon with a good follow-up of postoperative care. However, there remains to explore more on the duration of obstetric fistula recovery and determinant factors. The aim of this study was to estimate the average recovery time of obstetric fistula and to identify its determinants in Gondar University teaching and referral hospital, northwest Ethiopia. A retrospective follow up study was conducted at Gondar University teaching and referral hospital. A total of 612 fistula cases were included in the study and simple random sampling technique was applied to select the study subjects. Kaplan-Meier and log rank test were computed to explore the data. Weibull regression survival model with univariate frailty was done to identify the determinant factors of time to recovery. Of 612 fistula patients, 539(88.07%) were recovered. The Average (median) recovery time was 5.14 (IQR?=?3.14, 9.14) weeks. Using Antibiotic (AHR?=?1.49, 95% CI?=?1.11–2.01), having history of antenatal care (ANC) (AHR?=?1.95, 95% CI?=?1.39–2.73), being literate (AHR?=?2.23, 95% CI?=?1.62–3.06), duration of bladder catheterization (AHR?=?0.93, CI?=?0.90–0.95) and being multiparous (AHR?=?1.51, 95% CI?=?1.17–1.96) were a significant predictors of the rate of recovery. Also, underweight (AHR?=?0.45, 95% CI?=?0.30–0.68), overweight (AHR?=?0.56, 95% CI?=?0.41–0.76), being obese (AHR?=?0.41, 95% CI?=?0.21–0.80), having extensive fistula (AHR?=?0.82, 95% CI?=?0.73–0.91), large fistula (AHR?=?0.42, 95% CI?=?0.23–0.78), medium width (AHR?=?0.62, 95% CI?=?0.43–0.91) and large width (AHR?=?0.42, 95% CI?=?0.23–0.78) were statistically significant predictors of the rate of recovery from fistula patients. The average recovery time from obstetric fistula patients was 5.14?weeks. Small Length and width of fistula, patients’ educational status (literacy), antibiotic use, history of antenatal care visits, normal BMI, short period catheterization and being multiparous were the significant determinate variables which shorten the recovery time of obstetric fistula.