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An evaluation of the impact of post-hysterectomy vesicovaginal fistula repair on the mental health of patients in a developed country

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Abstract

Introduction and hypothesis

Obstetric vesicovaginal fistulae (VVFs) occur frequently as a result of childbirth in developing countries, but occurrence of VVFs in developed countries is rare and is generally observed after hysterectomy. Moreover, there are no reports regarding the effect of post-hysterectomy VVF repair on the patients’ mental health in developed countries. Our study aimed to confirm the effect of post-hysterectomy VVF repair on Japanese iatrogenic VVF patients’ mental health.

Methods

A retrospective chart review was performed for 31 patients who underwent post-hysterectomy VVF repair. Each patient’s urinary incontinence and mental state were evaluated using two questionnaires, the International Consultation on Incontinence Questionnaire-Short Form and the Hospital Anxiety and Depression Scale questionnaires, respectively, at baseline and at 3 or 6 months post-surgery. The Wilcoxon signed-rank test was used to compare the pre- and post-repair scores of each questionnaire, while McNemar’s test was used to compare the pre- and post-repair proportions of patients with anxiety and depression.

Results

Of the 31 patients, 13 (41.9%) underwent hysterectomy because of malignancies. All questionnaire scores showed significant improvement after VVF repair. The prevalence of clinical anxiety and depression decreased from 51.6% to 16.1% (P < 0.01) and from 51.6% to 12.9% (P < 0.01), respectively, after VVF repair, and urine leakage through fistulae was not observed in any patient after VVF repair.

Conclusions

Our results suggest that iatrogenic VVF can have severe impacts on patients’ mental health, but VVF repair can significantly improve it.

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References

  1. Wall LL. Obstetric vesicovaginal fistula as an international public-health problem. Lancet. 2006;368(9542):1201–9.

    Article  Google Scholar 

  2. Weston K, Mutiso S, Mwangi JW, Qureshi Z, Beard J, Venkat P. Depression among women with obstetric fistula in Kenya. Int J Gynaecol Obstet. 2011;115:31–3.

    Article  Google Scholar 

  3. Browning A, Fentahun W, Goh JT. The impact of surgical treatment on the mental health of women with obstetric fistula. BJOG. 2007;114:1439–41.

    Article  CAS  Google Scholar 

  4. Ahmed S, Holtz SA. Social and economic consequences of obstetric fistula: life changed forever? Int J Gynaecol Obstet. 2007;99(Suppl 1):S10–5.

    Article  Google Scholar 

  5. Umoiyoho AJ, Inyang-Etoh EC, Abah GM, Abasiattai AM, Akaiso OE. Quality of life following successful repair of vesicovaginal fistula in Nigeria. Rural Remote Health. 2011;11:1734.

    PubMed  Google Scholar 

  6. Hilton P, Cromwell DA. The risk of vesicovaginal and urethrovaginal fistula after hysterectomy performed in the English National Health Service—a retrospective cohort study examining patterns of care between 2000 and 2008. Br J Obstet Gynaecol. 2012;119:1447–54.

    Article  CAS  Google Scholar 

  7. Hesselman S, Bergman L, Högberg U, Jonsson M. Risk of fistula formation and long-term health effects after a benign hysterectomy complicated by organ injury: a population-based register study. Acta Obstet Gynecol Scand. 2018;97:1463–70.

    Article  Google Scholar 

  8. Hospital Intelligence Agency. https://hospia.jp/dpc. Accessed 26 Dec 2018.

  9. Karantanis E, Fynes M, Moore KH, Stanton SL. Comparison of the ICIQ-SF and 24-hour pad test with other measures for evaluating the severity of urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2004;15:111–6.

    Article  Google Scholar 

  10. Goto M, Donovan J, Corcos J, Badia X, Kelleher CJ, Naughton M, Shaw C,Avery K, Honma Y (2001) ICIQ-SF(international consultation on incontinence-questionnaire: short form). Journal of Japanese continence society 12: 227-231.

    Google Scholar 

  11. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.

    Article  CAS  Google Scholar 

  12. Herrmann C. International experiences with the hospital anxiety and depression scale—a review of validation data and clinical results. J Psychosom Res. 1997;42(1):17–41.

    Article  CAS  Google Scholar 

  13. Coyne KS, Kvasz M, Ireland AM, Milsom I, Kopp ZS, Chapple CR. Urinary incontinence and its relationship to mental health and health-related quality of life in men and women in Sweden, the United Kingdom, and the United States. Eur Urol. 2012;61:88–95.

    Article  Google Scholar 

  14. Felde G, Ebbesen MH, Hunskaar S. Anxiety and depression associated with urinary incontinence. A 10-year follow-up study from the Norwegian HUNT study (EPINCONT). Neurourol Urodyn. 2017;36:322–8.

    Article  Google Scholar 

  15. Zeleke BM, Ayele TA, Woldetsadik MA, Bisetegn TA, Adane AA. Depression among women with obstetric fistula, and pelvic organ prolapse in Northwest Ethiopia. BMC Psychiatry. 2013;13:236.

    Article  Google Scholar 

  16. Barageine JK, Beyeza-Kashesya J, Byamugisha JK, Tumwesigye NM, Almroth L, Faxelid E. "I am alone and isolated": a qualitative study of experiences of women living with genital fistulain Uganda. BMC Women’s Health. 2015;15:73.

    Article  Google Scholar 

  17. Worldwide Fistula Fund. What Is Fistula? https://worldwidefistulafund.org/what-is-fistula.aspx. Accessed 23 Jan 2019.

  18. Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH. Poverty and access to health care in developing countries. Ann N Y Acad Sci. 2008;1136:161–71.

    Article  Google Scholar 

  19. Kinjo M, Yamaguchi T, Tambo M, Okegawa T, Fukuhara H. Effects of mirabegron on anxiety and depression in female patients with overactive bladder. Urol Int. 2019;102:331–5.

    Article  Google Scholar 

  20. Lee D, Dillon BE, Lemack GE, Zimmern PE. Long-term functional outcomes following nonradiated vesicovaginal repair. J Urol. 2014;191:120–4.

    Article  Google Scholar 

  21. Abou-El-Ghar ME, El-Assmy AM, Refaie HF, El-Diasty TA. Radiological diagnosis of vesicouterine fistula: role of magnetic resonance imaging. J Magn Reson Imaging. 2012;36:438–42.

    Article  Google Scholar 

  22. Fujisaki A, Kinnno K, Shimoinaba M, Honda S, Takazawa N, Hosoda S, Yoshimura Y. Method for the diagnosis and repair of vesicovaginal fistulae. The 104th Annual Meeting of the Japanese Urolpgical Association; 2016 Apr 23-25; Sendai, Japan. Japanese.

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Acknowledgments

We thank Editage (www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Urology, Yotsuya Medical Cube, Tokyo, Japan

    Akiko Fujisaki, Misa Shimoinaba, Shuko Honda & Yasukuni Yoshimura

  2. Department of Urology, Kyorin University School of Medicine, Tokyo, Japan

    Manami Kinjo

  3. Female Pelvic Health Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

    Yasukuni Yoshimura

Authors
  1. Akiko Fujisaki
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  2. Manami Kinjo
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  3. Misa Shimoinaba
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  4. Shuko Honda
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  5. Yasukuni Yoshimura
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Correspondence to Akiko Fujisaki.

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The 2018 annual meeting of the International Urogynecology Association, Vienna, Austria, June 27–30, 2018.

The 2018 annual meeting of the Asia Pacific Urogynecology Association, Kuala Lumpur, Malaysia, September 23, 2018.

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Fujisaki, A., Kinjo, M., Shimoinaba, M. et al. An evaluation of the impact of post-hysterectomy vesicovaginal fistula repair on the mental health of patients in a developed country. Int Urogynecol J 31, 1371–1375 (2020). https://doi.org/10.1007/s00192-019-04131-4

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  • DOI: https://doi.org/10.1007/s00192-019-04131-4

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