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A qualitative study on the perceptions of patients with vesicovaginal fistula

Siddharth Saraf, Uttam Kumar Paul, Dilip Kumar Pal.

Abstract
Background: Vesicovaginal fistula (VVF) is a grave complication of gynecological surgeries and vaginal deliveries, leading to physical, psychological, and social implications. In India, due to the high patient turnover, it is not uncommon to find such patients in every region. While various works elaborate the surgical aspect of VVF, there is a dearth of literature on qualitative research.

Objective: This study was done to better understand the impact of physical, psychological, and social factors on the lives of patient with VVF.

Materials and Methods: This study was conducted in the department of urology at a tertiary care hospital. It was a descriptive qualitative study that involved audio recorded in-depth interviews of 18 such patients followed by their transcription and qualitative data analysis.

Results: We identified five major categories from the transcripts, namely, understanding of the disease, initial reaction of the patient, reaction of the husband and family, personal and physical discomfort, and social implications. While majority of the perceptions were also reported in the previous studies, we found some unique perceptions in the form of false perception of urine leak from urethra in spite of vagina and blaming, the birth of female child for bad luck was found in our study. Another favorable unique response not noted in other studies was excellent family support in half of the patients.

Conclusion: Our study supports the idea that VVF has far deeper implications other than physical discomfort. This study promotes wholesome management of patients, family, and society using a multidisciplinary approach.

Key words: Vesicovaginal Fistula; Psychological; Perceptions; Qualitative Study



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