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Open Access Research article

Depression among women with obstetric fistula, and pelvic organ prolapse in northwest Ethiopia

Berihun Megabiaw Zeleke1*, Tadesse Awoke Ayele1, Mulatu Adefris Woldetsadik2, Telake Azale Bisetegn3 and Akilew Awoke Adane1

Author Affiliations

1 Epidemiology and Biostatistics department, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

2 Department of Gynaecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

3 Department of Reproductive Health and Health Education, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

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BMC Psychiatry 2013, 13:236  doi:10.1186/1471-244X-13-236

Published: 26 September 2013

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.

Keywords:
Depression; Pelvic organ prolapse; Obstetric fistula; Ethiopia