{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:24:48Z","timestamp":1747182288705,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007915","name":"Baylor College of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007915","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe and compare baseline renal anatomy and renal function in patients with obstetric fistulas, and to evaluate whether preoperative renal testing and imaging may aid with operative decision making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Fistula Care Centre in Malawi.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with an obstetric fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Baseline creatinine testing and renal ultrasounds were performed. Surgeons completed a short questionnaire on the usefulness of creatinine and renal ultrasound on operative decision making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Baseline creatinine and renal ultrasound findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four surgeons performed operations on 85 patients. The mean creatinine in patients with vesicovaginal fistulas (VVF) was 0.60\u00a0ng\/ml versus patients with uretero\u2010vaginal fistulas (UVF) (0.79\u00a0ng\/ml, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.012). When a grade 3 or more hydronephrosis is absent on renal ultrasound, the negative predictive value of the presence of UVF is 93.3% (95% confidence interval [CI] 88.6\u201396.2) with a specificity of 97.2% (95% CI 90.3\u201399.6). In cases of UVF, surgeons found the renal ultrasound results useful or very useful 87.5% of the time, and the creatinine useful or very useful 75% of the time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this pilot study, most patients with obstetric fistulas presented with a normal creatinine. In the absence of a grade 3 hydronephrosis or above on renal ultrasound, the probability of not having a UVF is 93.3%. Surgeons should consider performing preoperative renal ultrasound testing in all patients with an obstetric fistula, particularly in women with a prior laparotomy, as this population has risk factors for ureterovaginal fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Most patients with obstetric fistulas have normal renal function. Preoperative renal ultrasounds should be performed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16106","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T14:12:30Z","timestamp":1579615950000},"page":"897-904","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Baseline renal function and renal ultrasound findings in patients with obstetric fistulas (RENFRU): a prospective cohort study"],"prefix":"10.1111","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9713-2736","authenticated-orcid":false,"given":"OH","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Global Women\u2019s Health, Obstetrics and Gynecology Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MJ","family":"Stokes","sequence":"additional","affiliation":[{"name":"Department of Global Women\u2019s Health, Obstetrics and Gynecology Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Chalamanda","sequence":"additional","affiliation":[{"name":"Freedom from Fistula Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Department of Global Women\u2019s Health, Obstetrics and Gynecology Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RJ","family":"Pope","sequence":"additional","affiliation":[{"name":"Freedom from Fistula Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.02.007"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69476-2"},{"volume-title":"Urogynecology and Reconstructive Pelvic Surgery","year":"2005","author":"Walters MD","key":"e_1_2_6_4_1"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3483-4"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2445-3"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016341003801698"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.12.019"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-145-4-200608150-00004"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-11-201306040-00007"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02012459"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"volume-title":"R: A language and environment for statistical computing","year":"2014","author":"R Core Team","key":"e_1_2_6_13_1"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2004.00315.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2018.30.203.15345"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9260(76)80122-5"},{"key":"e_1_2_6_17_1","first-page":"999","article-title":"Ureterovaginal fistula\u2014etiological factors and outcome","volume":"62","author":"Murtaza B","year":"2012","journal-title":"JPMA J Pak Med Assoc"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.01.018"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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