Risk factors for developing residual stress urinary incontinence after vesico-vaginal fistula repair: A retrospective cohort study

Previous studies have identified predictors for residual urinary incontinence after successful closure of fistula. However, these findings remain uncertain because the predictors vary from one study to another. The present study aimed to examine the risk of residual stress urinary incontinence after successful closure of vesico-vaginal fistula (VVF). We conducted a multicenter retrospective cohort study over 07-years period, from 1st January, 2010 to 31 December, 2016. We included women who underwent VVF repair in one of the seven fistula centers. At three months postoperatively, a cough test was performed among patients who had their fistula successfully closed. The predicted outcome was the urinary continence status after sussessful closure of the fistula and was categorized as (Residual stress urinary incontinence and No Residual stress urinary incontinence). Multivariable binary logistic regression model was performed to analyze association between outcome and predictors. Overall fistula closure rate at 3 months was 88.6% (404/456). Of the patients who had their fistula successfully closed, 16.3% (66/404) experienced a residual stress urinary incontinence. Risk factors for residual stress urinary incontinence in univariate analysis were: urethro-vesical junction involvement, circumferential fistula, Goh type 3, fistula size greater than 3cm, previous fistula repair, urethra involvement. Three independent predictors have been identified: urethro-vesical junction involvement, previous fistula repair and type 3 of Goh's classification. This study showed that the rate of residual stress urinary incontinence is high in our setting. The involvement of sphincteric mechanism is the main predictor. 3. La présente étude visait à examiner le risque d’incontinence urinaire résiduelle à l'effort après la fermeture réussie d'une fistule vésico-vaginale(FVV). Nous avons mené une étude de cohorte rétrospective multicentrique sur une période de 7 ans, du 1er janvier 2010 au 31 décembre 2016. Nous avons inclus les femmes ayant subi une réparation de FVV dans l'un des sept centres de prise en charge des fistules. Trois mois après l'opération, un test de toux a été réalisé chez les patientes ayant eu une fermeture réussie de leur fistule. Le critère de jugement principal était l'état de la continence urinaire après la fermeture de la fistule, qui a été catégorisé comme suit : incontinence urinaire résiduelle à l'effort et absence d'incontinence urinaire résiduelle à l'eff