PSYCHOLOGICAL AND SOCIAL IMPACT ON THE LIVES OF VESICOVAGINAL FISTULA PATIENTS PRE- AND POST-OPERATIVE SURGICAL REPAIR.
DOI:
https://doi.org/10.52764/jms.26.34.2.9Keywords:
Vesicovaginal fistula (VVF), surgical repair, psychological impact, social reintegration, quality of life.Abstract
Objective: This study evaluated the psychological and social changes in patients undergoing surgical repair for VVF.
Methods: A cross-sectional study was conducted in the Department of Urology at Khyber Teaching Hospital, Peshawar, from May 2019 to September 2024. Seventy patients with confirmed VVF were enrolled. Diagnosis was established by cystoscopy and vaginoscopy. Surgical repair was performed 4–6 weeks after onset, followed by three days of hospitalization and regular follow-up. Psychological and social outcomes were assessed using validated tools and the Patient Global Impression of Improvement (PGI-I) scale at three months.
Results: The mean age of participants was 40.6 ± 10.2 years; 78.9% were multiparous. The mean fistula size was 11.5 ± 4.5 mm, with supratrigonal fistulas more common (60.6%). Hysterectomy was the leading cause (46.5%), followed by cesarean section (29.6%) and difficult labor (16.9%). The overall closure success rate was 90.1%, with higher rates in smaller fistulas (p = 0.02). Patients with failed repairs had longer hospital stays (5.1 ± 0.7 vs. 3.7 ± 0.7 days, p < 0.001). Minor complications occurred in 14.2% of cases. Psychological distress decreased significantly after surgery; persistent incontinence was associated with higher PTSD and depression. Over 90% reported symptom improvement (PGI-I < 3).
Conclusion: Early surgical repair of VVF yields high closure rates and substantial psychological and social recovery. Comprehensive care, including psychosocial support, is essential for optimal reintegration and quality of life.
Keywords: Vesicovaginal fistula (VVF), surgical repair, psychological impact, social reintegration, quality of life.
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Copyright (c) 2026 Iqra Masood, Hazrat Ullah, Murad Ali, Muhammad Anees, Muhammad Sabir, Asghar Ali
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