Persistent depression after obstetric fistula repair

Mary J. Stokes, Jeffrey P. Wilkinson, Prakash Ganesh, William Nundwe, Rachel J. Pope

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objective: To measure depression over time using the Patient Health Questionnaire 9 (PHQ-9) and identify characteristics associated with persistent depression. Methods: A database of women undergoing obstetric fistula repair was used to examine associations between depression and variables such as demographics, type of fistula, and postoperative continence status. Results: A total of 797 patients completed the PHQ-9 at the initial preoperative assessment; 365 (45.8%) had a PHQ-9 score of 5 or higher, indicating depression. Preoperatively, depression was associated with women aged 18–34 years, with no children, and with fistula for 5 years or less. Postoperatively, depression was associated with persistent incontinence. Over time, however, depression was rarely found among women returning for follow-up. Conclusion: Postoperative depression decreased over time in women who returned for follow-up, either due to selection bias or due to improved adjustment to one's circumstances. This study underscores the need for ongoing follow-up, especially for those not presenting for care or with persistent incontinence.

Original languageEnglish (US)
Pages (from-to)206-211
Number of pages6
JournalInternational Journal of Gynecology and Obstetrics
Issue number2
StatePublished - Nov 1 2019
Externally publishedYes


  • Depression
  • Global women's health
  • Incontinence
  • Maternal health
  • Mental health
  • Obstetric fistula

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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