Incidence of intimate partner violence among Ugandan women with pelvic floor dysfunction

OBJECTIVE

To assess the occurrence of intimate partner violence (IPV) among women seeking surgery for pelvic floor dysfunction (PFD) in a rural African community.

METHODS

A prospective questionnaire-based study was conducted among women with obstetric fistula, unrepaired obstetric anal sphincter injuries (OASIS), or severe (stage 3 or 4) pelvic organ prolapse (POP) who attended surgical camps at Kagando Hospital in western Uganda between July 15, 2016, and September 14, 2017. The control group comprised women without PFD. Participants completed the Hurt, Insult, Threaten, and Scream (HITS) tool and the Woman Abuse Screening Tool (WAST) to screen for IPV.

RESULTS

117 of the 312 women interviewed reported current IPV: 73/214 (34.1%) in the PFD group and 44/98 (44.9%) in the control group. The PFD group comprised unrepaired OASIS (n=85, 39.7%), obstetric fistula (n=75, 35.1%), and severe POP (n=54, 25.2%). All groups experienced high levels of IPV. The frequency of positive screening results for IPV with WAST (score ≥13.0) and/or HITS (score ≥10.5) were: severe POP (n=17, 31.5%), obstetric fistula (n=28, 37.3%), unrepaired OASIS (n=30, 35.3%), and control group (n=44, 44.9%).

CONCLUSION

Women in western Uganda experienced high rates of IPV, regardless of whether or not they had PFD. ANZCTR number: ACTRN12617001073392.

Mental health screening in women with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula in western Uganda

INTRODUCTION AND HYPOTHESIS

High levels of mental health dysfunction have been identified in women with genital tract fistula. The aim of this study was to use the General Health Questionnaire-28 (GHQ-28) to screen women in western Uganda with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula for risk of mental health dysfunction.

METHODS

Women undergoing surgery for severe pelvic organ prolapse, chronic fourth-degree obstetric tear, and genital tract fistula were interviewed using the GHQ-28 to screen for the risk of mental health dysfunction.

RESULTS

A total of 125 women completed the GHQ-28, including 22 with pelvic organ prolapse, 47 with fourth-degree obstetric tear, 21 with genital tract fistula, and 35 controls. Nearly all women with these serious gynaecological conditions were positive for the risk of mental health dysfunction. In the domain assessing symptoms of severe depression, women with fourth-degree obstetric tear and genital tract fistula scored higher than women with pelvic organ prolapse.

CONCLUSIONS

A significant risk of mental health dysfunction was identified in women with severe pelvic organ prolapse and chronic fourth-degree obstetric tear. These rates are similar to the high rates of mental health dysfunction in women with genital tract fistula. Identification and management of mental health dysfunction in women with these conditions should be a priority.