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International Urogynecology Journal

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01-09-2021 | Care | Review Article

Rehabilitative care practices in the management of childbirth-related pelvic fistula: A systematic review

Authors: Laura Keyser, Jessica McKinney, Lauren Hosterman, Chi Chiung Grace Chen

Published in: International Urogynecology Journal | Issue 9/2021

Abstract

Introduction and hypothesis

Childbirth-related pelvic fistula (CRF) often requires surgery, yet even with successful repair, mental health conditions, musculoskeletal impairments, urinary and fecal incontinence and sexual dysfunction persist for many women. Postoperative rehabilitation, (i.e., physiotherapy, mental health counseling) may address these concerns and has been reported for this population. This review aims to summarize the literature and level of evidence of rehabilitative care practices in fistula care to inform clinical practice, research and policy recommendations.

Methods

A systematic literature review was conducted using Africa-Wide Information, CINAHL, Cochrane, Embase, Global Health, PAIS Index, PubMed and SCOPUS searching keywords and MeSH terms to identify women with CRF admitted for surgery. Two researchers progressively screened titles, abstracts and full-text articles. Eligible articles were classified primary if intervention details and outcomes were reported or secondary if rehabilitation was described, but no specific outcomes reported. Relevant study details, strengths and limitations, and key findings were extracted.

Results

Eighteen articles were included: eight primary, ten secondary. Primary articles reported on urethral plugs for postoperative urinary incontinence (UI) (2/8), menstrual cup to manage UI (1/8), physiotherapy and health education (3/8) and mental health counseling (2/8). Secondary articles describe rehabilitation components in the context of program descriptions, qualitative analyses or reviews. All evidence was low or very low quality.

Conclusions

Research on rehabilitative care is very limited and highlights inconsistencies in practice. This review provides support for the feasibility of rehabilitation and establishes the need for future interventional studies that involve a comparator and reliable outcome measures.

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Title: Rehabilitative care practices in the management of childbirth-related pelvic fistula: A systematic review
Authors: Laura Keyser
Jessica McKinney
Lauren Hosterman
Chi Chiung Grace Chen
Publication date: 01-09-2021
Publisher: Springer International Publishing
Keywords: Care
Urinary Incontinence
Urinary Incontinence
Published in: International Urogynecology Journal / Issue 9/2021
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-021-04845-4

At a glance: The STEP trials

Springer Medicine

Rehabilitative care practices in the management of childbirth-related pelvic fistula: A systematic review

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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