DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175829

Management of Vesicouterine fistulae during fistulae surgical caravan in Cote d'Ivoire

Djanhan L. E., Dia J. M., Menin M. M., Bohoussou E., Kouamé B., Samaké Y., Kouakou K. P., Doumbia Y.

Abstract


Background: The urogenital fistula (UGF) which designate a solution of continuity between the urinary and genital tracts in women, are divided into several entities of variable gravity. The objective of this study was to describe the epidemiological, clinical and therapeutic characteristics of patients treated for vesicouterine fistula during ‘fistulas surgical caravans’.

Methods: This was a prospective and descriptive study on a cohort of 34 patients treated for Vesico-uterine fistulae during ‘‘fistulas surgical caravans '' from 1st January 2012 to 31st December 2016.

Results: Vesico uterine fistulae represented 2.1% of all urogenital fistulae treated. At the time of occurrence of fistulas, the average age of the patients stay was 33.3 years, and the majority was not educated (88.2%), lived in rural areas without occupations (73.5%). All the fistulae were secondary to childbirth, the majority of which took place on a scarred uterus (67.6%). And this childbirth responsible for the fistula was done by caesarean section in 97.7% of cases. Then the average duration of the fistula before management was 6 years. Finally, all the patients were operated by the same surgical technique, made by abdominal extra peritoneal transvesical way. The cure rate after this surgical technique was 97.1% (33 patients). The only case of failure required a second operation by another technique which permitted the healing of the patient.

Conclusions: The vesicouterine fistulae were rare and the satisfactory results of their management invite us to sustain these surgical caravans and ensure their widespread.


Keywords


Diagnosis, Epidemiology, Vesico-uterine fistula, Treatment

Full Text:

PDF

References


Kaboré AF, Kambou T, Ouattara A, Zango B, Yaméogo C, Kirakoya B, et al. Epidemiology, etiology and psychosocial impact of urogenital fistulas in a cohort of 170 consecutive patients managed in three treatment centers in Burkina Faso from 2010 to 2012. Prog Urol. 2014;24:526-32.

Schlienger G, Laroche J, Karsenty G, Bertrand S, Dulac JP, Fournier R, et al. Obstetrical Vesicovaginal fistula for single visiting surgeons in Africa. Medicine and Tropical Health. 2012;22:126-30.

Martius H. The operative restoration of the totally missing urethra and the shooting muscle of the same. Central Blu Gynakol. 1928;52:480.

Baumet M. Vesico-uterine fistulas J. Chir. 1975;110:307-16.

Benchekroun A, Lacklar A, Soumana A, Farik M.H.

Vesico-uterine fistulas: about 30 cases. Ann Urol. 1999;33:75-9.

Trabelsi N, Makni MY, Guermazi H, Boujnah H, Zmerli S. Vesico-uterine fistulas: about 6 cases. Ann Urol. 1989;23:113-6.

Drissi M, Karmouni T, Tazi K, Khader EK, Koutani A, Attya IA, et al. Vesicouterine fistulas: an experience of 17 years. Prog Urol. 2008;18(3):173-6.

Loué V, Traore M, Koffi A, Adjoby R, Kouame A, Akpa Y, et al. Obstetric Vesicouterine fistulas: about 26 cases managed at Cocody’s University Hospital. J Gynecol Obstet. 2017;5(1):20-4.

Onsrud M, Sjoveian S, Mukwege D. Cesarean delivery-related fistulae in the Democratic Republic of Congo. Int J Gynecol Obstet. 2011;114:10-4.

Lenkovsky Z, Poded D, Shapiro A, Caine M. Vesicouterine fistula: a rare complication of cesarean section. J Urol. 1988;139:123-5.

Ozmen E, Yal C, Gulhan N, Unal S. Vesico-uterine fistula (Youssef’s syndrome): case report. Int Urol Nephrol. 1998;30:451-3.

Afriat R, Casanova JM, Bercau G, Sauvanet E, Freund M, Bidat L. Vesico-uterine fistula occurring after normal delivery ina woman with previous cesarean section. J Gynecol Obstet Biol Reprod. 1997;637-40.

Lugagne PM, Leo JP, Richard F. Uro-genital fistulas. EMC Gynecol. 1996;220(A10):5.

Bohoussou E, Kouamé B, Lebeau R, Saki C, Yao I, Okon G, et al. Vesico-vaginal fistula of obstetric origin: about 68 cases taken charge at the hospital of man (Ivory Coast). Journal de la SAGO. 2015;6(2):11-5.

El Moussaoui A, Aboutaie R, Bennani S, Elmrinim, Meziane F, Benjelloun S. Les fistules vésico-utérines. J Urol. 1994;100:143-6.

Sylla C, Fall A, Diallo A, Ndoya A, Ba M, Gueye S, et al. Vesico-uterine fistulae. Report of 5 cases. Prog Urol. 2000;4(10):634-7.

Taika A, Kamal EM, Aboutaieb R, Samouh N, Himmi A. Youssef’s syndrome. Prog Urol. 2001;11:78-81.

Issa M, Schmid HP, Stamey TA. Youssef’s syndrome: Preservation of uterine function with subsequent successful pregnancy following surgical repair. Urol Int. 1994;52:220-2.