Women’s physical and psychosocial health improves dramatically after fistula repair

The severe physical, psychological and social consequences of obstetric fistula have made the problem a global health priority. As many as 2 million women globally may be affected. In addition to helping more women access surgery, better knowledge of women’s post-surgical recovery from fistula is important for improving quality of life among affected women.

New research from the Bixby Center and partners is the first to look at year-long trajectories of physical and psychosocial health after fistula repair surgery in Uganda. Researchers found that most women reported dramatic improvements in their physical and psychosocial health, mostly within the first 6 months. The percentage of women who rated themselves as in excellent or good health jumped from 0% to 60%. Physical symptoms like urinary incontinence and general weakness saw large drops over time. However, some women continued to experience fistula-related symptoms after surgery; at twelve months, one-third of women reported urinary incontinence and 17% general weakness.

Self-esteem, depressive symptoms, social support and quality of life all improved over the 6 months after surgery, and remained steady afterwards. The women reported a reduction in stigma, though some negative self-perception remained at the end of the year. There was a strong relationship between lingering physical symptoms and negative psychosocial health.

These findings point to the importance of ensuring timely access to fistula repair surgery. They also suggest that other efforts beyond surgery may be necessary to best support women in achieving better mental and physical health after fistula repair.