Pelvic Health Initiative

This work aims to address the significant unmet need for research addressing delivery of healthcare to the millions of women suffering from pelvic floor disorders (PFDs) who lack access to specialized care. This part of our collaboration with Panzi Hospital in Bukavu, Democratic Republic of Congo. Our mutual vision is to set the standard for care of patients with PFDs while supporting Panzi staff at becoming leaders in their field.

There are multiple contributing factors to the high prevalence of PFDs in sub-Saharan African countries. We know that the risk for PFDs such as pelvic organ prolapse or urinary incontinence increases with the number of vaginal childbirths. Therefore, the problem of PFDs may be amplified in many countries this region, which has the highest births-per-woman rates in the world. Due to factors including infrastructure, childbirth complications such as obstetric fistula are also most prevalent in women living in sub-Saharan Africa.

Site: Panzi Hospital is located in Bukavu, the capital of the South Kivu province in Democratic Republic of Congo (DRC). The hospital serves as a teaching institution associated with University Evangelique Afrique and has a total capacity of 450 beds, of which 84 beds are devoted to urogynecological care of patients admitted for prolapse, obstetric fistula, as well as survivors of sexual violence. Although it is a general referral hospital serving the over 1 million local population, it is most known for its support for survivors of sexual violence and women suffering from obstetric fistula. Panzi Hospital was founded by 2018 Nobel Peace Laureate Dr. Denis Mukwege.

 

Current Project

Development of a Specialized Clinic for Pelvic Floor Disorders
Study Site: Panzi Hospital, Bukavu, Democratic Republic of Congo

In 2017, we established the first clinic in Eastern DRC with local physicians and staff with advanced training in a variety of sub-specialized clinical evaluation techniques. In addition to improving the quality of care provided to women suffering from PFDs, this clinic aims to increase capacity for conducting much needed research. Currently available evidenced-based approaches for treatment and management of PFDs rely on research carried out in high-resource settings. There's an urgent need for research aimed at identifying or developing the most appropriate approaches for treatment and management of PFDs in resource-limited settings. Projects that we are currently working on include those aimed at validating standardized questionnaires (such as those used to compare efficacy of treatments) in local and regional languages, determining the impact of low body mass index on reconstructive pelvic surgery outcomes, and developing improved treatment protocols for the significant proportion (10-55%) of patients who continue to suffer from incontinence despite fistula closure surgery.