Cargando…
Feasibility and acceptability of the menstrual cup for non-surgical management of vesicovaginal fistula among women at a health facility in Ghana
OBJECTIVE: To assess the feasibility of the menstrual cup for short-term management of urinary leakage among women with vesicovaginal fistula (VVF) METHODS: A repeated measures design compared volume of leakage with and without the cup via a 2-hr pad test among women with VVF seeking surgical repair...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261596/ https://www.ncbi.nlm.nih.gov/pubmed/30485344 http://dx.doi.org/10.1371/journal.pone.0207925 |
_version_ | 1783374976351469568 |
---|---|
author | Ganyaglo, Gabriel Y. K. Ryan, Nessa Park, Joonhee Lassey, A. T. |
author_facet | Ganyaglo, Gabriel Y. K. Ryan, Nessa Park, Joonhee Lassey, A. T. |
author_sort | Ganyaglo, Gabriel Y. K. |
collection | PubMed |
description | OBJECTIVE: To assess the feasibility of the menstrual cup for short-term management of urinary leakage among women with vesicovaginal fistula (VVF) METHODS: A repeated measures design compared volume of leakage with and without the cup via a 2-hr pad test among women with VVF seeking surgical repair at a health facility in Ghana. Subsequently a gynecological exam was administered to assess safety outcomes, followed by a questionnaire to assess acceptability and perceived efficacy. A paired t-test was used to analyze reduction of leakage in ml, and percent reduction was reported. Study limitations include observer bias while evaluating adverse outcomes and the possibility of social desirability bias during questionnaire administration that might overestimate the effect of the cup and women’s acceptability. RESULTS: Of the 32 patients screened, 11 were eligible (100% consent rate). At baseline, mean (±SD) leakage in ml was 63.2 (±49.2) (95% CI: 30.2–96.3) over two hours, while the mean leakage over two hours of use of the cup was 16.8 (±16.5) (95% CI: 5.7–27.9). The mean difference of 46.4 (±52.1) ml with use of the cup (95% CI: 11.4–81.4) was statistically significant (p = 0.02). With the cup, women experienced an average 61.0% (±37.4) (95% CI: 35.9–86.2) leakage reduction, a difference 10/11 users (91.0%) perceived in reduced leakage. One participant, reporting four previous surgical attempts, experienced a 78.7% leakage reduction. Acceptability was high—women could easily insert (8/11), remove (8/11), and comfortably wear (11/11) the cup and most (10/11) would recommend it. No adverse effects attributable to the intervention were observed on exam, although some women perceived difficulties with insertion and removal. Data collection tools were appropriate with slight modification advised. CONCLUSION: A larger trial is warranted for a more robust evaluation of the menstrual cup for management of urinary leakage due to VVF among women who have not yet accessed surgery or for whom surgery was not successful. |
format | Online Article Text |
id | pubmed-6261596 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-62615962018-12-19 Feasibility and acceptability of the menstrual cup for non-surgical management of vesicovaginal fistula among women at a health facility in Ghana Ganyaglo, Gabriel Y. K. Ryan, Nessa Park, Joonhee Lassey, A. T. PLoS One Research Article OBJECTIVE: To assess the feasibility of the menstrual cup for short-term management of urinary leakage among women with vesicovaginal fistula (VVF) METHODS: A repeated measures design compared volume of leakage with and without the cup via a 2-hr pad test among women with VVF seeking surgical repair at a health facility in Ghana. Subsequently a gynecological exam was administered to assess safety outcomes, followed by a questionnaire to assess acceptability and perceived efficacy. A paired t-test was used to analyze reduction of leakage in ml, and percent reduction was reported. Study limitations include observer bias while evaluating adverse outcomes and the possibility of social desirability bias during questionnaire administration that might overestimate the effect of the cup and women’s acceptability. RESULTS: Of the 32 patients screened, 11 were eligible (100% consent rate). At baseline, mean (±SD) leakage in ml was 63.2 (±49.2) (95% CI: 30.2–96.3) over two hours, while the mean leakage over two hours of use of the cup was 16.8 (±16.5) (95% CI: 5.7–27.9). The mean difference of 46.4 (±52.1) ml with use of the cup (95% CI: 11.4–81.4) was statistically significant (p = 0.02). With the cup, women experienced an average 61.0% (±37.4) (95% CI: 35.9–86.2) leakage reduction, a difference 10/11 users (91.0%) perceived in reduced leakage. One participant, reporting four previous surgical attempts, experienced a 78.7% leakage reduction. Acceptability was high—women could easily insert (8/11), remove (8/11), and comfortably wear (11/11) the cup and most (10/11) would recommend it. No adverse effects attributable to the intervention were observed on exam, although some women perceived difficulties with insertion and removal. Data collection tools were appropriate with slight modification advised. CONCLUSION: A larger trial is warranted for a more robust evaluation of the menstrual cup for management of urinary leakage due to VVF among women who have not yet accessed surgery or for whom surgery was not successful. Public Library of Science 2018-11-28 /pmc/articles/PMC6261596/ /pubmed/30485344 http://dx.doi.org/10.1371/journal.pone.0207925 Text en © 2018 Ganyaglo et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ganyaglo, Gabriel Y. K. Ryan, Nessa Park, Joonhee Lassey, A. T. Feasibility and acceptability of the menstrual cup for non-surgical management of vesicovaginal fistula among women at a health facility in Ghana |
title | Feasibility and acceptability of the menstrual cup for non-surgical management of vesicovaginal fistula among women at a health facility in Ghana |
title_full | Feasibility and acceptability of the menstrual cup for non-surgical management of vesicovaginal fistula among women at a health facility in Ghana |
title_fullStr | Feasibility and acceptability of the menstrual cup for non-surgical management of vesicovaginal fistula among women at a health facility in Ghana |
title_full_unstemmed | Feasibility and acceptability of the menstrual cup for non-surgical management of vesicovaginal fistula among women at a health facility in Ghana |
title_short | Feasibility and acceptability of the menstrual cup for non-surgical management of vesicovaginal fistula among women at a health facility in Ghana |
title_sort | feasibility and acceptability of the menstrual cup for non-surgical management of vesicovaginal fistula among women at a health facility in ghana |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261596/ https://www.ncbi.nlm.nih.gov/pubmed/30485344 http://dx.doi.org/10.1371/journal.pone.0207925 |
work_keys_str_mv | AT ganyaglogabrielyk feasibilityandacceptabilityofthemenstrualcupfornonsurgicalmanagementofvesicovaginalfistulaamongwomenatahealthfacilityinghana AT ryannessa feasibilityandacceptabilityofthemenstrualcupfornonsurgicalmanagementofvesicovaginalfistulaamongwomenatahealthfacilityinghana AT parkjoonhee feasibilityandacceptabilityofthemenstrualcupfornonsurgicalmanagementofvesicovaginalfistulaamongwomenatahealthfacilityinghana AT lasseyat feasibilityandacceptabilityofthemenstrualcupfornonsurgicalmanagementofvesicovaginalfistulaamongwomenatahealthfacilityinghana |