A comparison of quality of life before and after successful repair of genitourinary fistula: Is there improvement across all the domains of WHOQOL-BREF questionnaire?

Abstract

Objective: To compare preoperative quality of life (QoL) scores using World Health Organization WHOQOL-BREF quality of life assessment with postoperative  QoL scores following successful repair of genitourinary fistula.

Patients and methods: The WHOQOL-BREF questionnaire was used as a tool to evaluate the quality of life before and after surgical repair. All patients, who underwent genitourinary fistula repair between  January 2011 and December 2013 were included. Women with complaints of continuous leakage of urine  per vagina following obstetric or gynaecological procedures were included in this study. Women with  rectovaginal fistula, malignant fistula or radiation induced fistula were excluded from this study. Patients  with comorbidities affecting QoL and those who did not give consent to participate were excluded.  Patients whose questionnaire was incomplete were also excluded.

Results: Of the 106 women admitted for treatment of genitourinary fistula during the time period; 101 were included. The preoperative score of physical,  psychological, social and environmental health domains were 15.04 ± 2.56, 16.42 ±  4.4, 51.75 ± 11.91 and 34.81 ± 6.89 respectively. The  postoperative scores in physical, psychological, social and environmental health domains were 83.61 ± 5.09, 75.79 ± 6.33, 76.17 ± 8.53 and 33.88 ± 6.13 respectively. On comparison between the  preoperative and postoperative QoL scores; there was significant improvement in physical,  psychological  and social health domains in the postoperative period (p < 0.01) but the environmental health domain scores remained static.

Conclusion: There is marked improvement in the overall quality of life, especially the physical,  psychological and social health domains of WHOQOL-BREF questionnaire after successful surgical repair  of genitourinary fistula. The environmental health domain remained unchanged even after successful  repair.

KEYWORDS: Genitourinary fistula; WHOQOL-BREF questionnaire; Quality of life