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Outcomes in obstetric fistula care: a literature review

Arrowsmith, Steven D.; Barone, Mark A.; Ruminjo, Joseph

Current Opinion in Obstetrics & Gynecology:
doi: 10.1097/GCO.0b013e3283648d60
UROGYNECOLOGY: Edited by Narender Bhatia

Purpose of review: To highlight the lack of consistency in the terminology and indicators related to obstetric fistula care and to put forward a call for consensus.

Recent findings: Recent studies show at least some degree of statistical correlation between outcome and the following clinical factors: degree of scarring/fibrosis, fistula location, fistula size, damage to the urethra, presence of circumferential fistula, bladder capacity, and prior attempt at fistula repair.

Summary: Consensus about basic definitions of clinical success does not yet exist. Opinions vary widely about the prognostic parameters for success or failure. Commonly agreed upon definitions and outcome measures will help ensure that site reviews are accurate and conducted fairly. To properly compare technical innovations with existing methods, agreement must be reached on definitions of success. Standardized indicators for mortality and morbidity associated with fistula repair will improve the evidence base and contribute to quality of care.

Author Information

EngenderHealth, Fistula Care, New York, New York, USA

Correspondence to Mark A. Barone, DVM, MS, EngenderHealth, 440 Ninth Avenue, New York, NY 10001, USA. Tel: +1 212 561 8000; fax: +1 212 561 8067; e-mail:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins