{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:23:06Z","timestamp":1787775786996,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,12,27]],"date-time":"2018-12-27T00:00:00Z","timestamp":1545868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R25 TW009340"],"award-info":[{"award-number":["R25 TW009340"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 HD075731"],"award-info":[{"award-number":["T32 HD075731"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24 AI120796"],"award-info":[{"award-number":["K24 AI120796"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      We evaluated residual incontinence, depression, and quality of life among Malawian women who had undergone vesicovaginal fistula (\n                      <jats:styled-content style=\"fixed-case\">VVF<\/jats:styled-content>\n                      ) repair 12 or more months previously.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Fistula Care Centre in Lilongwe, Malawi.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>\n                      Women who had undergone\n                      <jats:styled-content style=\"fixed-case\">VVF<\/jats:styled-content>\n                      repair in Lilongwe, Malawi at least 12\u00a0months prior to enrolment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Self\u2010report of urinary leakage was used to evaluate for residual urinary incontinence; depression was evaluated with the Patient Health Questionnaire\u20109; quality of life was evaluated with the King's Health Questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Prevalence and predictors of residual incontinence, quality of life scores, and prevalence of depression and suicidal ideation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010six women (19.3%) reported residual urinary incontinence. In multivariable analyses, predictors of residual urinary incontinence included: pre\u2010operative Goh type 3 [\n                      <jats:styled-content style=\"fixed-case\">adjusted risk ratio (aRR)<\/jats:styled-content>\n                      2.82; 95%\n                      <jats:styled-content style=\"fixed-case\">confidence interval (CI<\/jats:styled-content>\n                      ) 1.61\u20135.27) or Goh type 4 1.08\u20132.78), positive postoperative cough stress test (\n                      <jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content>\n                      \u00a0=\u00a02.42; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.24\u20134.71) and the positive 1\u2010hour postoperative pad test (\n                      <jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content>\n                      \u00a0=\u00a02.20; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.08\u20134.48). Women with Goh types 3 and 4\n                      <jats:styled-content style=\"fixed-case\">VVF<\/jats:styled-content>\n                      reported lower quality of life scores. Depressive symptoms were reported in 3.5% of women; all reported residual urinary incontinence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      While the majority of women reported improved outcomes in the years following surgical\n                      <jats:styled-content style=\"fixed-case\">VVF<\/jats:styled-content>\n                      repair, those with residual urinary incontinence had a poorer quality of life. Services are needed to identify and treat this at\u2010risk group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>Nearly one in five women reported residual urinary incontinence at follow up, 12 or months after vesicovaginal fistula repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.15546","type":"journal-article","created":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T03:20:16Z","timestamp":1542770416000},"page":"926-934","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study"],"prefix":"10.1111","volume":"126","author":[{"given":"DM","family":"Kopp","sequence":"first","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"},{"name":"Department of Obstetrics and Gynecology University of North Carolina Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JH","family":"Tang","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"},{"name":"Department of Obstetrics and Gynecology University of North Carolina Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AM","family":"Bengtson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Brown University Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BH","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of North Carolina Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Chipungu","sequence":"additional","affiliation":[{"name":"Fistula Care Center Lilongwe Malawi"},{"name":"Department of Obstetrics and Gynaecology Malawi College of Medicine Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Moyo","sequence":"additional","affiliation":[{"name":"Fistula Care Center Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Fistula Care Center Lilongwe Malawi"},{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69476-2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70348-1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.06.011"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e3283648d60"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-007-0367-z"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-015-0755-1"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01162.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)34769-7"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01900.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1028-4559(10)60063-0"},{"key":"e_1_2_6_12_1","unstructured":"World Health Organization WH.Malawi: Country Cooperation Strategy.2017. [http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/136935\/ccsbrief_mwi_en.pdf;jsessionid=A2A7F94A5AE51E3407AB4CFF3A33F483?sequence=1]. Accessed 1 May 2018."},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb11006.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.06.003"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.05.056"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.06.001"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11469-017-9829-9"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14505"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22436"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2004.00315.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02200.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12086"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31826579e8"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.09.028"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-012-1774-3"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.01.018"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2010.551519"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)35406-8"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.04.015"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-13-236"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01419.x"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000050"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-013-0387-2"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2017-000625"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.15546","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.15546","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.15546","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.15546","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T08:17:52Z","timestamp":1694247472000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.15546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,27]]},"references-count":35,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1111\/1471-0528.15546"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.15546","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,27]]},"assertion":[{"value":"2018-10-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}