Successful surgical repair outcomes and determinants among obstetric fistula patients: a multi-centre study from Ethiopia

Background: Obstetric fistula is a life-altering form of complex obstetric injury caused by prolonged obstructed labour. It remains a significant public health concern in developing countries, particularly in regions across the northern half of sub-Saharan Africa and in parts of the Middle East and South Asia. Many women undergo surgery to repair their fistulas; however, there are inconsistent reports in the literature regarding surgical repair outcomes, particularly in Ethiopia. Methods: The study was undertaken at six treatment centres in Ethiopia using a longitudinal cohort design among 386 women with obstetric fistula. The participants underwent surgical repair of their fistula and were followed up until their outcome was determined. The data were collected using a structured questionnaire and an electronic data collection tool, Research Electronic Data Capture. The collected data were exported in various formats and analysed using R software. Results: The study revealed that 77.5 % of the participants achieved successful surgical repair. Underweight body mass index (BMI) (AOR: 0.68, 95 %CI = 0.252, 1.977), having an alive child (AOR: 3.19, 95 %CI = 1.089, 9.638), fistula length > 2 cm (AOR: 0.40, 95 %CI = 0.183, 0.851) and urethral damage (AOR: 0.41, 95 %CI = 0.221, 0.753) showed significant associations with successful surgical repair outcomes. Conclusion: While many obstetric fistula repairs are successful, the overall success rate in Ethiopia falls below the World Health Organization's recommendation. Collaborative efforts are needed to revise the treatment approaches to meet the World Health Organization's standards.