{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:18:00Z","timestamp":1772252280332,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T00:00:00Z","timestamp":1610409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to establish the postoperative success rates of midvaginal versus juxtacervical obstetric vesicovaginal fistula (VVF) repairs. In addition, we aim to quantify the impact of patient sociodemographic variables, fistula classification, and surgical repair techniques associated with postoperative outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted involving 420 women who had undergone a primary obstetric VVF repair. All data were collected from the Panzi Hospital, Democratic Republic of Congo between 2015 and 2017. Patient notes were analyzed to determine sociodemographic variables, symptoms, fistula classification, surgical repair techniques, and postoperative follow up. Binary logistic regression presented as \u03c7<jats:sup>2<\/jats:sup> for trend was used to establish <jats:italic>P<\/jats:italic> values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 95.6% and 96.2% of midvaginal and juxtacervical VVF, respectively, underwent a successful repair. The principal prognostic factor associated with a statistically significant likelihood of a successful repair was the degree of fibrosis noted preoperatively (<jats:italic>P\u00a0<\/jats:italic>=0.004, 95% confidence interval [CI] 2.38\u201394.61). Furthermore, VVF were more likely to have a successful repair if they were closed in two layers (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.004, 95% CI 1.86\u201325.81) and sutured vertically (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.005, 95% CI 1.16\u20132.52).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overall, high postoperative success rates of obstetric VVF repair can be expected among well\u2010trained surgeons but a complex interplay of factors means that the ability to preoperatively foreshadow individual outcomes remains difficult.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13472","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T03:05:45Z","timestamp":1604891145000},"page":"294-299","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Obstetric vesico\u2010vaginal fistulas: Midvaginal and juxtacervical fistula repair outcomes in the Democratic Republic of Congo"],"prefix":"10.1002","volume":"153","author":[{"given":"Raha","family":"Maroyi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Panzi General Referral Hospital, Universit\u00e9 Evangelique en Afrique (UEA) Bukavu The Democratic Republic of Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usama","family":"Shahid","sequence":"additional","affiliation":[{"name":"College of Medicine and Dentistry, James Cook University Townsville Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkat","family":"Vangaveti","sequence":"additional","affiliation":[{"name":"College of Medicine and Dentistry, James Cook University Townsville Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Rane","sequence":"additional","affiliation":[{"name":"College of Medicine and Dentistry, James Cook University Townsville Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Mukwege","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Panzi General Referral Hospital, Universit\u00e9 Evangelique en Afrique (UEA) Bukavu The Democratic Republic of Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"1328","article-title":"\u2018Fitsari dan duniya\u2019: an African (Hausa) praise song about vesio\u2010vaginal fistula","volume":"100","author":"Wall LL","year":"2002","journal-title":"Obstet Gynaecol."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1983.tb08933.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-018-0605-1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.08.021"},{"key":"e_1_2_8_6_1","volume-title":"Beyond the Numbers\u2013Reviewing Maternal Deaths and Complications to Make Pregnancy Safer","year":"2004"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(95)02350-L"},{"key":"e_1_2_8_8_1","volume-title":"WHO Library Cataloguing\u2010in\u2010Publication Data Obstetric Fistula: Guiding Principles for Clinical Management and Programme Development","year":"2006"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2004.00315.x"},{"key":"e_1_2_8_10_1","volume-title":"Practical Obstetric Fistula Surgery","author":"Hancock B"},{"key":"e_1_2_8_11_1","first-page":"s837","article-title":"Associations between obstetric fistula location and mode of delivery and post\u2010repair incontinence. 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