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Citation Information

Type Journal Article - BMC Psychiatry
Title Depression among women with obstetric fistula, and pelvic organ prolapse in northwest Ethiopia
Author(s)
Volume 13
Issue 1
Publication (Day/Month/Year) 2013
Page numbers 1-5
URL http://www.biomedcentral.com/1471-244X/13/236
Abstract
Background: The prevalence of depression is not well studied among women with pelvic floor disorders. Hence,
this study aimed to determine the prevalence of depression and its associated factors among women with pelvic
floor disorders.
Methods: A cross-sectional study was conducted among 306 women with one or more of the advanced pelvic
floor disorders who attended at the gynaecologic outpatient clinic of Gondar university referral hospital in the six
months data collection period. Women who complained of urinary or faecal incontinence or protruding mass per
vagina were assessed and staged accordingly. Eligible women i.e. those with advanced pelvic organ prolapse or
obstetric fistula were included consecutively. A structured questionnaire was used to obtain socio-demographic
data and medical histories for all consenting women. Interviews were done by a female midwife nurse. Depression
measures were obtained using the Beck’s Depression Inventory (BDI) tool administered by the midwife nurse after
intensive training. Data were entered into a computer using Epi Info version 3. 5.3, and then exported to SPSS
version 20 for analysis. Multiple logistic regressions were fitted and Odds ratios with 95% confidence intervals were
calculated to identify associated factors.
Results: Of the 306 women interviewed, 269 had advanced pelvic organ prolapse (stages 3 and 4), 37 had obstetric
fistula. All four women (100%) with both faecal and urinary incontinence, 97.0% those with urinary incontinence
due to obstetric fistula and 67.7% of those with advanced pelvic organ prolapse (stages 3 and 4) had symptoms of
depression. Depression was significantly associated with age 50 years or older (P < 0.01), marital status (P < 0.05), history
of divorce (p < 0.01), self perception of severe problem (P < 0.05), and having stage 3 pelvic organ prolapse (P < 0.01).
Conclusion: Women with advanced pelvic organ prolapse, and obstetric fistula had high prevalence of depressive
symptoms. A holistic management approach, including mental health care is recommended for women having such
severe forms of pelvic floor disorders.

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