{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T14:17:20Z","timestamp":1769523440918,"version":"3.49.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T00:00:00Z","timestamp":1656028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["7200AA20CA00011"],"award-info":[{"award-number":["7200AA20CA00011"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["AID-OAA-A14-00013"],"award-info":[{"award-number":["AID-OAA-A14-00013"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Womens Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Despite high closure rates, residual urinary incontinence remains a common problem after successful closure of a vesico-vaginal fistula. The objective of this study was to identify factors associated with residual urinary incontinence in women with successful fistula closure in sites supported by the Fistula Care <jats:italic>Plus<\/jats:italic> project in the Democratic Republic of Congo (DRC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>This was a retrospective cohort study using routine data extracted from the medical records of women undergoing fistula surgery in three hospitals supported by the Fistula Care Plus project in DRC between 2017 and 2019. We analyzed factors associated with residual urinary incontinence among a subsample of women with closed fistula at discharge. We collected data on sociodemographic, clinical, gynecological-obstetrical characteristics, and case management. Univariate and multivariate analyses were performed to determine the factors associated with residual urinary incontinence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 31 of 718 women discharged with closed fistula after repair (4.3%; 95% CI: 3.1\u20136.1) had residual incontinence. The leading causes identified in these women with residual incontinence were urethral voiding (6 women), short urethra (6 women), severe fibrosis (3 women) and micro-bladder (2 women). The prevalence of residual incontinence was higher among women who received repair at the Heal Africa (6.6%) and St Joseph's (3.7%) sites compared with the Panzi site (1.7%). Factors associated with increased odds of persistent urinary incontinence were the Heal Africa repair site (aOR: 54.18; 95% CI: 5.33\u2013550.89), any previous surgeries (aOR: 3.17; 95% CI: 1.10\u20139.14) and vaginal surgical route (aOR: 6.78; 95% CI: 1.02\u201345.21).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prior surgery and repair sites were the main predictors of residual incontinence after fistula closure. Early detection and management of urinary incontinence and further research to understand site contribution to persistent incontinence are needed.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fgwh.2022.896991","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T06:24:07Z","timestamp":1656051847000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Factors Associated With Persistent Urinary Incontinence Among Women Undergoing Female Genital Fistula Surgery in the Democratic Republic of Congo From 2017 to 2019"],"prefix":"10.3389","volume":"3","author":[{"given":"Dolores","family":"Nembunzu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomie","family":"Mayemba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidikiba","family":"Sidib\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fassou Mathias","family":"Grovogui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian Tena Tena","family":"Aussak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Don F\u00e9licien","family":"Banze Kyongolwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bienvenu Salim","family":"Camara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vandana","family":"Tripathi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Delamou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1016\/S0140-6736(06)69476-2","article-title":"Obstetric vesicovaginal fistula as an international public-health problem","volume":"368","author":"Wall","year":"2006","journal-title":"The Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1186\/s12884-015-0592-2","article-title":"Obstetric fistula in low-resource countries: an under-valued and under-studied problem \u2013 systematic review of its incidence, prevalence, and association with stillbirth","volume":"15","author":"Cowgill","year":"2015","journal-title":"BMC Pregnancy Childbirth."},{"key":"B3","unstructured":"10 facts on Fistule Obst\u00e9tricales2018"},{"key":"B4","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1097\/OGX.0b013e3182438788","article-title":"Preventing obstetric fistulas in low-resource countries: insights from a haddon matrix","volume":"67","author":"Wall","year":"2012","journal-title":"Obstet Gynecol Surv"},{"key":"B5","unstructured":"GenevaWorld Health OrganizationTrends in Maternal Mortality: 1990 to 2015: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division2015"},{"key":"B6","unstructured":"UN report on obstetric fistula 2018. 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