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Results of the Management of Urogenital Fistulae from Community Caravans

Open Journal of Obstetrics and Gynecology 2017年第8期7卷 858-865页

作者： Eric Bohoussou Jean Marc Dia Gerard Okon Lydie Djanhan Bilé Kouamé Yao Djanhan gabriel gnanazan Serges Boni Department of Gynecology and Obstetrics University and Hospital Center of Treichville (CHUT) Abidjan Cote d’Ivoire National Coordinator Fistula Project UNFPA Abidjan Cote d’Ivoire Department of Gynecology and Obstetrics University and Hospital Center of Bouaké (CHUB) Bouaké Cote d’Ivoire Department of Urology University and Hospital Center of Treichville (CHUT) Abidjan Cote d’Ivoire Department of Gynecology and Obstetrics University and Hospital Center of Cocody (CHUC) Abidjan Cote d’Ivoire

Objective: To report the experience of surgical caravans for urogenital fistulas care. Methodology: This was a retrospective study covering the period from January 2014 to December 2014 and which took place on 7 sites of fistula care. The epidemiological, anatomoclinical, therapeutic and evolutionary aspects were studied. Results: 346 patients were operated during 14 caravans. Their average age was 33.11 years (range: 12 to 70 years). Most of these patients were without remunerative activities (80%) and without education (63.3%). The average duration of fistula progression was 6.08 years (range: 0 to 42 years). Obstetrical etiology was predominant (87.9%). According to the classification of Kees Waaldijk, fistulas were divided into type I (67.4%), type II (21.1%), and type III (11.5%). The most common surgical approach was the transvaginal route (82.1%). The vesicovaginal splitting with separated suture of the bladder and the vagina was the basic technique (94.7%). The therapeutic results were judged after a follow-up of 1 month and 3 months. Across the cohort, 80 patients (23.1%) were lost of sight for follow-up at 1 month and 245 (70%) at 3 months. The success rates evaluated in patients reviewed at 1 month and 3 months were respectively 70% and 64%. Conclusion: The incidence of urogenital fistulas is still high in Cote d'Ivoire. Various anatomoclinical varieties have been identified and treated with satisfactory results in poorly equipped local structures.

关键词： Urogenital Fistulas Epidemiology Diagnosis Treatment

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