Psychosocial Morbidity of Patients Before and After Surgical Correction of Vesicovaginal Fistula

Objective: To compare mean preoperative and postoperative quality of life scores using the World Health Organization Quality of Life–BREF (WHOQOL-BREF) questionnaire following successful repair of genitourinary fistula. Methodology: A comparative cross-sectional study was conducted in the Department of Gynecology and Obstetrics, Isra University Hospital, Hyderabad, from December 30, 2020, to June 30, 2021. Women aged 20 to 60 years who presented with complaints of continuous leakage of urine per vagina following obstetric or gynecological procedures and underwent surgical repair were included. The WHOQOL-BREF questionnaire was used to assess quality of life before surgery. Surgical repair was performed in all participants, and quality of life was reassessed six weeks postoperatively. Data were recorded on a specially designed proforma and analyzed using SPSS version 22. Results: A total of 101 women with vesicovaginal fistula (VVF) were included. The mean age of the patients was 37.70 ± 10.96 years. The majority of women (55.4%) had poor preoperative physical domain scores according to the WHOQOL-BREF. Successful surgical repair was achieved in 98.0% of cases. Overall, 30.7% of women had poor quality of life (WHOQOL score < 40), 67.3% had moderate quality of life (WHOQOL score 41–60), and only two women had good quality of life (WHOQOL score > 60), likely because these women had mild disease and strong social and family support. Psychosocial and overall quality of life scores significantly improved after treatment (p = 0.001). The mean preoperative QOL score was 33.56 ± 9.33 (indicating a poor environmental domain), which improved to 80.07 ± 9.55 after treatment (indicating good quality of life) (p = 0.001). Conclusion: Preoperative quality of life was observed to be poor among women with vesicovaginal fistula; however, it significantly improved to a good level following successful surgical repair, as measured by the WHOQOL-BREF scoring system.