Kopp DM, et al. - Among Malawian women who had vesicovaginal fistula (VVF) repair 12 or more months earlier, researchers conducted a prospective cohort study at Fistula Care Centre in Lilongwe, Malawi to evaluate residual incontinence, depression, and quality of life. Residual urinary incontinence was reported in 56 women (19.3%). Multivariable analyses revealed pre-operative Goh type 3 or Goh type 4, positive postoperative cough stress test, and the positive 1-hour postoperative pad test as predictors of residual urinary incontinence. Lower quality of life scores was noted for women with Goh types 3 and 4 VVF. They noted depressive symptoms in 3.5% of women, all of whom reported residual urinary incontinence. As per these findings, improvement in outcomes was evident in the majority of women following surgical VVF repair, but poorer quality of life was seen in those with residual urinary incontinence. This emphasizes the necessity for services to identify and treat this at-risk group.