HIV Clinical Trial
Official title:
Physical, Psychological, and Reproductive Outcomes of Women After Obstetric Fistula Repair
The purpose of this study is to describe the long-term surgical success, quality of life,
prevalence of depression, fertility rates, and pregnancy outcomes of patients who have
undergone obstetric fistula repair.
This will be a study involving up to 300 women 1-3 years after they have undergone obstetric
fistula repair at the Fistula Care Center in Lilongwe, Malawi.
Patients who underwent obstetric fistula repair between January 1, 2012 and July 31, 2014
will be identified from an existing database of fistula patients. They will then be contacted
and invited to participate in the study. Consented patients will complete a 1-hour pad weight
to evaluate urinary continence, a demographic questionnaire, an incontinence-related quality
of life metric, and a depression metric. The data will be analyzed and then disseminated to
stakeholders.
Eligible participants will be identified from an existing, secure database. Participants will
be contacted and traced. They will then be invited to participate in the study. If a
participant agrees to participate in the study, they will undergo informed consent by trained
study staff, using IRB-approved informed consent forms. They will then undergo a 1-hour pad
weight, complete demographic data, complete an incontinence-related quality of life metric,
and complete a depression metric.
1-hour pad weight: Use of the 1-hour pad weights have been recommended as an objective
measure of treatment outcome for anti-incontinence procedures. After a woman has agreed to
enroll in the study and has given written consent, she will be asked to complete a 1-hour pad
weight. Pad weights will be measured through having participants sit on a pre-weighed pad for
exactly one hour and re-weighing the same pad. The weight of the pad before and after will be
recorded and the difference between the two will be used as the pad weight. The pad weight
represents the degree of urinary leakage a woman is experiencing. In continent populations,
this weight is <1.5 grams. The research assistant will use a calibrated portable scale and
stopwatch to ensure accurate recording of these weights. During this time, the remainder of
the survey will be conducted.
Demographic Data: Demographic data for each participant will be collected at the time of
enrollment and after a written consent has been obtained. This includes information about the
patient's age, place of residence, HIV status, education attainment, living arrangement,
number of pregnancies and living children, and symptoms of urinary or fecal leakage.
Incontinence-related Quality of Life Metric: To assess OF repair success and continence,
participants will be asked about any leakage symptoms with the Kings' Health Questionnaire.
Depression Metric:The 9-question Patient Health Questionnaire (PHQ-9) will be used to assess
repaired OF participants for depression.
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