Les fistules uro-génitales iatrogènes: À propos de 62 cas et revue de la littérature

Conclusion Les fistules urogénitales iatrogènes deviennent une complication relativement fréquente de la césarienne et de l’hystérectomie dans les pays en développement y compris le Niger. Bien que leur traitement chirurgical assure un taux élevé de succès, l’accent doit être mis sur la prévention par l’amélioration des formations en chirurgie et de la pratique des soins obstétricaux d’urgence de qualité. Objectives To identify types of iatrogenic genitourinary fistula, their circumstances of occurrence, diagnostic tools and to assess the surgical treatment outcomes. Patients and Methods This prospective study conducted from January 2009 to July 2014 in the Urology department at Lamordé national hospital and the national referral centre for obstetric fistula (CNRFO) is based on 62 cases of iatrogenic fistulae. The main variables are fistula types, circumstances of occurrence, diagnostic tools and management outcomes. Results The following fistulae have been registered: vesico-uterine (40 cases), trigono-vaginal (3 cases), uretero-vaginal (14 cases) and urethro-vaginal (5 cases). The contexts of occurrence are C-section, hysterectomy, instrumental delivery and “yankan gishiri” procedure. Gynecologic exam, methylene blue test, intravenous indigo carmine and cystoscopy using a condom are specific tips that help confirm diagnosis. All cases except one have been successfully treated surgically. Conclusion Iatrogenic genitourinary fistulae are bec...
Source: African Journal of Urology - Category: Urology & Nephrology Source Type: research