Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania

Wilson SM, Sikkema KJ, Watt MH, Masenga GG
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Obstetric fistula is a childbirth injury prevalent in sub-Saharan Africa that causes uncontrollable leaking of urine and/or feces. Research has documented the social and psychological sequelae of obstetric fistula, including mental health dysfunction and social isolation.


This cross-sectional study sought to quantify the psychological symptoms and social support in obstetric fistula patientscompared with a patient population of women without obstetric fistula.


Participants were gynecology patients (N = 144) at the Kilimanjaro Christian Medical Center in Moshi, Tanzania, recruited from the FistulaWard (n = 54) as well as gynecology outpatient clinics (n = 90). Measures included previously validated psychometric questionnaires, administered orally by Tanzanian nurses. Outcome variables were compared between obstetric fistula patients and gynecology outpatients, controlling for background demographic variables and multiple comparisons.


Compared to gynecology outpatientsobstetric fistula patients reported significantly higher symptoms of depression, post-traumatic stress disorder, somatic complaints, and maladaptive coping. They also reported significantly lower social support.


Obstetric fistula patients present for repair surgery with more severe psychological distress than gynecology outpatients. In order to address these mental health concerns, clinicians should engage obstetric fistula patients with targeted mental health interventions.