# Prevalence and Risk Factors of Urinary Incontinence After Successful Vesicovaginal Fistula Repair

## TL;DR

This study finds that the type of vesicovaginal fistula, especially circumferential ones, is a key risk factor for urinary incontinence after successful repair, affecting about 8% of patients.

## Contribution

The study identifies fistula type as an independent predictor of postoperative urinary incontinence after successful VVF repair.

## Key findings

- Postoperative urinary incontinence occurred in 7.78% of patients after successful VVF repair.
- Circumferential fistula type was significantly associated with UI and confirmed as an independent predictor.
- Demographic and socioeconomic factors had indirect effects on UI outcomes.

## Abstract

Introduction

Residual urinary incontinence (UI) following anatomically successful vesicovaginal fistula (VVF) repair remains a major postoperative challenge, often compromising quality of life despite surgical closure. Persistent UI arises from a combination of anatomical, obstetric, and sociodemographic influences, which differ across patient populations.

Objective

The objective of this study is to determine the prevalence and identify the risk factors associated with UI after successful VVF repair.

Methods

This descriptive study was conducted in the Department of Obstetrics and Gynecology Unit-II, Isra University Hospital, Hyderabad, over 12 months (August 2021 to August 2022). Ninety women who underwent anatomically successful VVF repair were enrolled using nonprobability consecutive sampling. Data regarding demographic, obstetric, and fistula-related variables were collected. Bivariate, stratified, and multivariable logistic regression analyses were performed. Continuous variables were summarized as mean ± SD or median (IQR), and categorical variables as n (%). A p-value <0.05 was considered statistically significant.

Results

The mean age of participants was 37.04 ± 6.79 years, and the mean BMI was 22.25 ± 2.13 kg/m². Most women were from rural areas (77.8%), illiterate (61.1%), and of low socioeconomic status (73.3%). Postoperative UI occurred in seven (7.78%) women. Among evaluated factors, only fistula type showed a significant association (p = 0.005), with circumferential fistulae exhibiting the highest risk. Multivariable analysis confirmed fistula type as an independent predictor (adjusted odds ratio (aOR) = 6.82, p = 0.017).

Conclusion

Post-repair UI predominantly depends on fistula complexity, especially circumferential configuration, whereas demographic and socioeconomic factors exert indirect effects. Timely management and skilled surgical expertise remain critical for achieving optimal continence outcomes.