New hope for women with fistula injuries

May 21, 2018, University of Michigan
Dr. Denis Mukwege conducting rounds in the fistula ward and visiting a patient her bedside. Credit: University of Michigan

The health care systems in the United States and other industrialized countries have outgrown many of the childbirth-related injuries that are still very problematic in poor countries.

One of those is fistula, defined as a hole between the vagina and bladder that causes constant urine leakage through the vagina. In the Democratic Republic of Congo, where treatment for fistula isn't advanced and resources are scarce, a fistula is potentially catastrophic.

Part of the problem is that doctors don't have a good way to gauge the degree of the fistula injury in order to develop the appropriate treatment plan, said Janis Miller, a professor at the University of Michigan Nursing School and one of the authors of a new study on assessing and treating this injury.

To that end, Miller and her partners in the Congo have developed a method of scoring fistula injuries that will guide clinicians in determining treatment. They can either fix the fistula themselves or refer the woman to a specialist.

The tool, called the Panzi Score, will help physicians predict the success of surgery and make a path for treatment, said study co-author Alain Mukwege, a research associate at the U-M School of Nursing.

"If a fistula happens again, there is a greater risk of failure," Mukwege said.

Often, having difficult labors in developing countries must wait for days for medical , and in the meantime, tissue begins to die. The more tissue death there is, the tougher a fistula is to repair.

The condition can be socially and physically catastrophic for women, Miller said. The women are usually socially isolated and the leakage is acidic and constant, causing horrible sores.

The study included 837 women with fistula injuries who were treated at the Panzi Hospital DRC and its outreach clinics. Fistula severity was assessed and surgical success was ascertained, and researchers analyzed the data to select fistula characteristics predictive of surgical failure.

Miller said the Panzi Score was surprisingly accurate, and she hopes it will be widely adopted.

The study, "Panzi score as a parsimonious indicator of urogenital fistula severity derived from Goh and Waaldijk classifications," appears in the International Journal of Gynecology and Obstetrics.

Explore further: For Uganda's women, action on traumatic childbirth injury

More information: Denis Mukwege et al. Panzi score as a parsimonious indicator of urogenital fistula severity derived from Goh and Waaldijk classifications, International Journal of Gynecology & Obstetrics (2018). DOI: 10.1002/ijgo.12514

Related Stories

For Uganda's women, action on traumatic childbirth injury

December 3, 2014
After suffering the tragedy of giving birth to a stillborn child nine years ago, Anna Grace Amuko was left with a debilitating condition.

Mesenchymal stem cells offer novel treatment approach for Crohn's disease fistula

September 15, 2017
A growing body of clinical evidence shows that transplantation of a patient's own mesenchymal stem cells (MSCs) to achieve a cure and prevent recurrent of Crohn's disease-related fistula can be a safe and effective addition ...

Treating hypothyroidism to stop a stubborn surgical complication

March 7, 2018
Researchers at the University of Michigan have discovered a link between low thyroid hormone levels and wound healing complications.

Regenerative medicine offering new treatment for bronchopleural fistulas

June 24, 2016
For the first time in human application, Mayo Clinic researchers successfully closed an open wound on the upper chest caused by postoperative complications of lung removal.

New research shows promise for improving vascular access for hemodialysis patients

August 16, 2017
Approximately 500,000 Americans with end-stage renal disease rely on hemodialysis to survive. Hemodialysis requires repeated access to the blood. Failure to maintain adequate access to the vasculature is a major cause of ...

Recommended for you

New study reveals time and day women are most likely to give birth

June 15, 2018
A new study has found that the time and day that women give birth can vary significantly depending on how labour starts and the mode of giving birth.

Blood test for pregnant women can predict premature birth

June 7, 2018
A new blood test for pregnant women detects with 75-80 percent accuracy whether their pregnancies will end in premature birth. The technique can also be used to estimate a fetus's gestational age—or the mother's due date—as ...

Drug combination offers more effective care for patients suffering miscarriage

June 6, 2018
A combination of the drugs mifepristone and misoprostol can help bring closure to some women and their families suffering from miscarriage, and reduces the need for surgical intervention to complete the painful miscarriage ...

Genes, environment and schizophrenia—new study finds the placenta is the missing link

May 28, 2018
Hiding in plain sight, new research shines a spotlight on the placenta's critical role in the nature versus nurture debate and how it confers risk for schizophrenia and likely other neurodevelopmental disorders including ...

Vendors say pot eases morning sickness. Will baby pay a price?

May 22, 2018
(HealthDay)—Nearly 70 percent of Colorado marijuana dispensaries recommended pot products to manage early pregnancy-related morning sickness, new research reveals.

Pregnancy drug DES might have triggered ADHD in the grandchildren of women who used it

May 21, 2018
A study conducted by researchers at Columbia University's Mailman School of Public Health and Harvard T.H. Chan School of Public Health reported elevated odds for attention deficit hyperactivity disorder (ADHD) in the grandchildren ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.