Overview

Following standardized operating procedures in accordance with the process described in the WHO handbook for guideline development, WHO has issued a new recommendation on the length of bladder catheterization following surgical repair of a simple obstetric urinary fistula. Currently the length of catheterization is not standard and ranges from 5 to 42 days. The new guidance recommends a 7–10 day period of bladder catheterization to allow complete healing. Longer periods of catheterization can be inconvenient for the woman, her family and care providers as it is associated with more discomfort and inconvenience. It also increases the risk of infection and erosion related to catheterization; requires more intensive nursing care and costs more per patient.

The primary audience for this guideline is health-care professionals, particularly fistula surgeons and nurses providing postoperative care to women after surgery for obstetric urinary fistula. The guideline will also be useful to national and local policy-makers, and staff of nongovernmental and other organizations involved in fistula care services.

Contents

• Acknowledgements
• Acronyms and abbreviations
• Executive summary
  • Introduction
  • Target audience
  • Guideline development methods
  • Recommendation
  • Remarks
• 1. Introduction
  • 1.1. Background
  • 1.2. Rationale and objectives
  • 1.3. Target audience
  • 1.4. Scope of the guideline
• 2. Methods
  • 2.1. Contributors to the guideline
  • 2.2. Identification of the priority question and critical outcomes
  • 2.3. Evidence identification and retrieval
  • 2.4. Quality assessment and grading of the evidence
  • 2.5. Formulation of the recommendation
  • 2.6. Declaration of interests by external contributors
  • 2.7. Decision-making during the WHO Technical Consultation
  • 2.8. Document preparation
  • 2.9. Peer review
• 3. Results: recommendation and evidence
  • 3.1. Recommendation
  • 3.2. Summary of evidence
• 4. Research implications
• 5. Dissemination and implementation of the guideline
  • 5.1. Guideline dissemination and evaluation
  • 5.2. Guideline implementation
• 6. Applicability issues
  • 6.1. Anticipated impact on the organization of care and resources
  • 6.2. Monitoring and evaluating the impact of the guideline
• 7. Updating the guideline
• 8. References
• Annex 1. Guideline contributors: external experts and WHO staff
• Annex 2. Critical and important outcomes for decision-making
• Annex 3. Search strategy
• Annex 4. Summary and management of declared interests from Guideline Development Group (GDG) members
• Annex 5. Evidence-to-decision table

Suggested citation:

WHO recommendation on duration of bladder catheterization after surgical repair of simple obstetric urinary fistula. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO.

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