A systematic review and meta-analysis of urinary incontinence following successful obstetric fistula repair: findings from five countries in sub-Saharan Africa

Abstract Background Obstetric vesico-vaginal fistula is a known complication that can occur following damage to the bladder wall during prolonged obstructed labor and operative delivery. Urinary incontinence following the repair of obstetric fistula remains a significant health problem and can great...

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Main Authors: Gedion Asnake Azeze, Kirubel Eshetu Haile, Natnael Atnafu Gebeyehu, Sintayehu Solomon Kena, Tewodros Getachew Tsegaye, Amanuel Yosef Gebrekidan, Yitateku Alelgn, Gizachew Ambaw Kassie, Yordanos Sisay Asgedom
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Women's Health
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Online Access:https://doi.org/10.1186/s12905-025-03701-7
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author Gedion Asnake Azeze
Kirubel Eshetu Haile
Natnael Atnafu Gebeyehu
Sintayehu Solomon Kena
Tewodros Getachew Tsegaye
Amanuel Yosef Gebrekidan
Yitateku Alelgn
Gizachew Ambaw Kassie
Yordanos Sisay Asgedom
author_facet Gedion Asnake Azeze
Kirubel Eshetu Haile
Natnael Atnafu Gebeyehu
Sintayehu Solomon Kena
Tewodros Getachew Tsegaye
Amanuel Yosef Gebrekidan
Yitateku Alelgn
Gizachew Ambaw Kassie
Yordanos Sisay Asgedom
author_sort Gedion Asnake Azeze
collection DOAJ
description Abstract Background Obstetric vesico-vaginal fistula is a known complication that can occur following damage to the bladder wall during prolonged obstructed labor and operative delivery. Urinary incontinence following the repair of obstetric fistula remains a significant health problem and can greatly damage a women’s ability to function confidently. There are approximately two million women suffering from urinary incontinence following obstetric fistula repair, most of whom are primarily in Africa. Objective We aimed to systematically review and conduct meta-analysis on the magnitude of urinary incontinence among women following successful obstetric fistula repair in sub-Saharan African countries. Methods We thoroughly searched online database including Medline, Scopus, Science Direct, Excerpta Medica Database, African Journals Online and Google Scholar for eligible articles from their inception to November 10, 2024. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 checklist. To generate pooled prevalence of urinary incontinence, we used random-effects model. The presence of publication bias was determined using a funnel plot and Egger’s regression test. Results Out of 1044 articles found following our initial search and after titles and abstracts review, we considered 277 full text articles for inclusion. Lastly, a total of 12 articles from five sub-Saharan African countries comprising 6,104 participants met the inclusion criteria for quantitative meta-analysis. The pooled prevalence of urinary incontinence following obstetric fistula repair was 16.32% (95%CI: 11.80, 20.84; I2 = 96.5%, P < 0.001). Conclusion and implications Overall, our findings show post-fistula repair incontinence remains an important clinical problem. Therefore, we believe that policy planners and researchers of sub-Saharan African nations may use the findings of the current study for evidence based care planning and patient counseling strategy. Registration Registered in PROSPERO under protocol number CRD42023416541.
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spelling doaj-art-2f23dfbd0e4444ad9d5a6bbef2dedad32025-08-20T03:06:50ZengBMCBMC Women's Health1472-68742025-04-0125111010.1186/s12905-025-03701-7A systematic review and meta-analysis of urinary incontinence following successful obstetric fistula repair: findings from five countries in sub-Saharan AfricaGedion Asnake Azeze0Kirubel Eshetu Haile1Natnael Atnafu Gebeyehu2Sintayehu Solomon Kena3Tewodros Getachew Tsegaye4Amanuel Yosef Gebrekidan5Yitateku Alelgn6Gizachew Ambaw Kassie7Yordanos Sisay Asgedom8Department of Midwifery, College of Medicine and Health Sciences, Hawassa UniversitySchool of Nursing, College of Health Science and Medicine, Wolaita Sodo UniversitySchool of Midwifery, College of Health Science and Medicine, Wolaita Sodo UniversityDepartment of Midwifery, College of Medicine and Health Sciences, Hawassa UniversityDepartment of Midwifery, College of Medicine and Health Sciences, Hawassa UniversitySchool of Public Health, College of Health Science and Medicine, Wolaita Sodo UniversityDepartment of Midwifery, College of Medicine and Health Sciences, Hawassa UniversitySchool of Public Health, College of Health Science and Medicine, Wolaita Sodo UniversitySchool of Public Health, College of Health Science and Medicine, Wolaita Sodo UniversityAbstract Background Obstetric vesico-vaginal fistula is a known complication that can occur following damage to the bladder wall during prolonged obstructed labor and operative delivery. Urinary incontinence following the repair of obstetric fistula remains a significant health problem and can greatly damage a women’s ability to function confidently. There are approximately two million women suffering from urinary incontinence following obstetric fistula repair, most of whom are primarily in Africa. Objective We aimed to systematically review and conduct meta-analysis on the magnitude of urinary incontinence among women following successful obstetric fistula repair in sub-Saharan African countries. Methods We thoroughly searched online database including Medline, Scopus, Science Direct, Excerpta Medica Database, African Journals Online and Google Scholar for eligible articles from their inception to November 10, 2024. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 checklist. To generate pooled prevalence of urinary incontinence, we used random-effects model. The presence of publication bias was determined using a funnel plot and Egger’s regression test. Results Out of 1044 articles found following our initial search and after titles and abstracts review, we considered 277 full text articles for inclusion. Lastly, a total of 12 articles from five sub-Saharan African countries comprising 6,104 participants met the inclusion criteria for quantitative meta-analysis. The pooled prevalence of urinary incontinence following obstetric fistula repair was 16.32% (95%CI: 11.80, 20.84; I2 = 96.5%, P < 0.001). Conclusion and implications Overall, our findings show post-fistula repair incontinence remains an important clinical problem. Therefore, we believe that policy planners and researchers of sub-Saharan African nations may use the findings of the current study for evidence based care planning and patient counseling strategy. Registration Registered in PROSPERO under protocol number CRD42023416541.https://doi.org/10.1186/s12905-025-03701-7Urinary incontinence, obstetric fistulaVesico-vaginal fistulaObstetric fistula repairsub-Saharan Africa
spellingShingle Gedion Asnake Azeze
Kirubel Eshetu Haile
Natnael Atnafu Gebeyehu
Sintayehu Solomon Kena
Tewodros Getachew Tsegaye
Amanuel Yosef Gebrekidan
Yitateku Alelgn
Gizachew Ambaw Kassie
Yordanos Sisay Asgedom
A systematic review and meta-analysis of urinary incontinence following successful obstetric fistula repair: findings from five countries in sub-Saharan Africa
BMC Women's Health
Urinary incontinence, obstetric fistula
Vesico-vaginal fistula
Obstetric fistula repair
sub-Saharan Africa
title A systematic review and meta-analysis of urinary incontinence following successful obstetric fistula repair: findings from five countries in sub-Saharan Africa
title_full A systematic review and meta-analysis of urinary incontinence following successful obstetric fistula repair: findings from five countries in sub-Saharan Africa
title_fullStr A systematic review and meta-analysis of urinary incontinence following successful obstetric fistula repair: findings from five countries in sub-Saharan Africa
title_full_unstemmed A systematic review and meta-analysis of urinary incontinence following successful obstetric fistula repair: findings from five countries in sub-Saharan Africa
title_short A systematic review and meta-analysis of urinary incontinence following successful obstetric fistula repair: findings from five countries in sub-Saharan Africa
title_sort systematic review and meta analysis of urinary incontinence following successful obstetric fistula repair findings from five countries in sub saharan africa
topic Urinary incontinence, obstetric fistula
Vesico-vaginal fistula
Obstetric fistula repair
sub-Saharan Africa
url https://doi.org/10.1186/s12905-025-03701-7
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