Identification of Current Practices in Fistula Treatment: A qualitative review

In 2008, the Fistula Care Project in consultation with partners from several countries and USAID identified three research questions about clinical practice for fistula surgery of which little is currently known for possible clinical trial research. These three topics were identified as key areas that could lead to improved safety and success in fistula repair while maximizing the limited personnel and material resources available to low budget programs in an efficient and cost-effective way. The research questions were: Do prophylactic antibiotics assist in the recovery of women who have fistula surgery? What role does catheterization have in fistula care management? What are the best practices in the management of stress incontinence post fistula surgery? Before embarking on the development of randomized control clinical trials to answer one or more of these questions the Fistula Care project conducted a qualitative review of clinical practices. In January 2009 63 fistula surgeons from over 10 countries were contacted about participating in this review. A short questionnaire was emailed to those willing to participate. The goal of this review was to better understand how to frame questions for possible randomized clinical trials. The goal of conducting one or more clinical trials would be to produce findings that can influence formulation of policy and practice and lead to improved care for women living with fistula. During this presentation findings from the review and recommendations for next steps will be presented.