{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:14:37Z","timestamp":1747149277805,"version":"3.40.5"},"reference-count":6,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"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":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the ability of a previously published risk score to predict incontinence at discharge in women with vesicovaginal fistulas (VVF) and to examine how the score correlates with an independent assessment of surgical skill.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective cohort study including cases from January to June 2018. We evaluated operative records for factors associated with incontinence at hospital discharge, as well as relationships between a risk score cut\u2010point of 20 or more and surgical skill level. All women with VVF undergoing vaginal repair were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 176 individuals underwent repair; 23 were performed by beginner, 85 by intermediate, 47 by advanced, and 21 by expert surgeons. Factors found significantly associated with incontinence at hospital discharge included Goh classification, fistula size, circumferential fistula, and vaginal scarring. A score of 20 or more predicted residual incontinence with a negative predictive value of 92% (odds ratio 7.75, 95% confidence interval 2.95\u201322.34). Applying the score cut\u2010point of 20 or more, we found an increased proportion of \u201chigh\u2010risk\u201d cases allocated to surgeons with an increasing level of expertise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The correlation we observed between a risk score cut\u2010point of 20 or more, continence status, and an independent assessment of surgical skill is promising. Although the risk score is not meant to replace clinical judgment, it may provide a surgical trainee with an objective method of determining whether to operate or refer for optimal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13693","type":"journal-article","created":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T15:46:48Z","timestamp":1617464808000},"page":"502-507","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Obstetric fistula scoring tool for surgical trainees"],"prefix":"10.1002","volume":"156","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1097-7611","authenticated-orcid":false,"given":"Rachel","family":"Pope","sequence":"first","affiliation":[{"name":"Department of Urology University Hospitals Cleveland Medical Center  Cleveland OH USA"},{"name":"Department of Reproductive Biology University Hospitals Cleveland Medical Center  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Mernoff","sequence":"additional","affiliation":[{"name":"Joint Medical Program UCSF School of Medicine  San Francisco CA USA"},{"name":"UC Berkeley School of Public Health  Berkeley CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chisomo","family":"Chalamanda","sequence":"additional","affiliation":[{"name":"Freedom from Fistula  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela M.","family":"Bengtson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Brown University  Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"World Health Organization.WHO Obstetric fistula fact sheet.2018.https:\/\/www.who.int\/news\u2010room\/facts\u2010in\u2010pictures\/detail\/10\u2010facts\u2010on\u2010obstetric\u2010fistula."},{"key":"e_1_2_7_3_1","unstructured":"United Nations Population Fund.Intensifying efforts to end obstetric fistula; Report of the Secretary\u2010General. 2016.https:\/\/www.unfpa.org\/resources\/intensifying\u2010efforts\u2010end\u2010obstetric\u2010fistula"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001687"},{"issue":"2","key":"e_1_2_7_5_1","article-title":"Panzi score as a parsimonious indicator of urogenital fistula severity derived from Goh and Waaldjik classifications","volume":"142","author":"Mukwege D","year":"2018","journal-title":"IJGO"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3375-7"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.02.020"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.13693","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.13693","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.13693","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T09:13:19Z","timestamp":1692954799000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.13693"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,9]]},"references-count":6,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1002\/ijgo.13693"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.13693","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"type":"print","value":"0020-7292"},{"type":"electronic","value":"1879-3479"}],"subject":[],"published":{"date-parts":[[2021,6,9]]},"assertion":[{"value":"2021-01-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}