title: One-year follow-up of women who participated in a physiotherapy and health education program before and after obstetric fistula surgery.
abstract: OBJECTIVE
  To investigate whether the positive impact of a program of physiotherapy and health education on the outcome of obstetric fistula surgery was maintained after 1 year.
  
  
  METHODS
  The present follow-up analysis included 108 women who underwent obstetric fistula surgery at a center in Tanguiéta, Benin, between March 2011 and March 2012, and who had received a structured program of physiotherapy and health education before and after surgery. After discharge, follow-up visits were made 3, 6, and 12 months after surgery. The Ditrovie scale was used to measure quality of life (QoL), and continence and performance of the physiotherapy exercises were assessed.
  
  
  RESULTS
  Mean QoL score was 36.9 (range 16.0-49.0) before surgery. Overall, 84 women were followed up for 1 year. Their mean QoL score had improved significantly to 18.5 (range 10.0-47.0; P<0.001). Between hospital discharge and 1 year, the number of women with a closed fistula increased from 48 (57.1%) to 53 (63.1%) and the number with urinary stress incontinence reduced from 11 (13.1%) to 9 (10.7%).
  
  
  CONCLUSIONS
  Results obtained after surgery and physiotherapy were maintained at 1 year, and QoL had improved significantly. When women are encouraged to continue exercises, improvements are also seen in residual stress incontinence.
authors.affiliation: Rehabilitation Department, Cliniques Universitaires St Luc, Brussels, Belgium. Electronic address: yves.castille@uclouvain.be.
authors.forename: Yves-Jacques
authors.initials: YJ
authors.lastname: Castille
authors.affiliation: Rehabilitation Department, Hôpital St Jean de Dieu, Tanguiéta, Benin.
authors.forename: Chiara
authors.initials: C
authors.lastname: Avocetien
authors.affiliation: Gynecology Department, Hôpital St Jean de Dieu, Tanguiéta, Benin.
authors.forename: Dieudonné
authors.initials: D
authors.lastname: Zaongo
authors.affiliation: Urology Department, Polyclinique du Parc, Dole, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Colas
authors.affiliation: Vattikui Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: James O
authors.initials: JO
authors.lastname: Peabody
authors.affiliation: Urology Department, Clinique Générale Beaulieu, Geneva, Switzerland; Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Charles-Henry
authors.initials: CH
authors.lastname: Rochat
mesh_terms: D001541:Benin; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D026741:Physical Therapy Modalities; D011788:Quality of Life; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000209:etiology; D014719:Vesicovaginal Fistula / Q000534:rehabilitation / Q000601:surgery*
keywords: Health education; Obstetric fistula; Physiotherapy; Rehabilitation; Urinary incontinence