Surgical intervention on uterine fibromyoma in a country with limited resources: case of the gynaecology-obstetrics department of the Communal Medical Centre of Ratoma Conakry - Guinea

Mamadou H. Diallo, Ibrahima S. Balde, Amadou D. Diallo, Ousmane Balde, Fatoumata B. Diallo, Mamadou S. Fofana, Alhassane Sow, Alpha B. Barry, Telly Sy, Namory Keita


Background: In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform. The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management.

Methods: It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from January 1, 2015 to December 31, 2018 and a 1-year prospective study from January 1, 2019 to December 31, 2019.

Results: Authors collected 135 cases of uterine fibromyomas operated on out of a total of 260 cases of gynaecological pathologies, i.e. a frequency of 51.92%. Nulliparous women were the most concerned (45.18%), and women who attended school (60%) and those who did not attend school (40%). Women at home and housewives accounted for 42.20% and 54.07% respectively. Clinically, the circumstances of discovery were dominated by menometrorrhagia and menorrhagia respectively 77.77% and 68.14%. The large uterus was the most frequent physical sign found in 96.29% of cases. Uterine fibromyomas were recorded in 86.6% of cases in women with genital activity. The operative indications were dominated by the large polymyomatous uterus (64.44%), followed by hemorrhagic fibroma (18.52%) The surgical treatment was conservative in 92.60%. The total hysterectomy was performed in 7.40. Lethality was 1.4%.

Conclusions: The surgical management of fibroids contrasts conservative treatment (myomectomy) with radical treatment (hysterectomy) with multiple possible approaches (hysteroscopy, vaginal surgery, laparoscopy or laparotomy). In this context, only laparotomy was possible due to lack of equipment. Laparoscopy and hysteroscopy equipment are necessary for less invasive surgery.


Fibromyoma, Hysterectomy, Myomectomy, Ratoma

Full Text:



National College of French Gynecologists and Obstetricians (CNGOF): Abstract of Gynecology-Obstetrics, 2nd edition Masson, Paris; 2011:227-228.

Okogbo FO, Ezechi OC, Loto OM, Ezeobi PM. Uterine leimyomatan in South Western Nigeria: a clinical study of presentations and management outcome. Afr Health Sci. 2011;11(2):271-8.

Bajekal N, Li TC. Fibroids, infertility and pregnancy wastage. Hum Report Update; 2000;6:614-20.

Baldé IS, Diallo BS, Conté I, Baldé O, Diallo MH, Diallo BC, et al. Uterine fibromyomas: epidemiological and clinical aspects, surgical management and prognosis at Conakry University Hospital Rev int sc méd-RISM6. 2015;17(3):118-24.

Sy T, Diallo Y, Diallo AB, Diallo FB, Touré A, Keita N, Diallo MS. Uterine fibromyomas: epidemioclinical aspect and surgical management at the Ignace Deen gynecology-obstetrics clinic of the CHU of Conakry. Ann Univer Ouagadougou- série D. 2007;5:113-26.

Mahbouli S, Messaoudi Y, Chandoul Y, Zayene H, Messaoudi F, Basly M, et al. management of uterine fibroids (about 219 cases), Tunisie Méd. vol 79-N°. 2001;10:515-20.

Laghzaoui M, Boukaidi S, Bouhya S, Hermas S, Bennani O, Aderdour M. epidemiology of uterine fibroids (about 690 cases). Maroc Med. 2001;23(4):266-70.

Dia A, Beye SB, Dangou JM, Dieng M, Woto Gaye CT. Uterine fibroids at the Dakar University Clinic: about 140 cases operated on in two years Dakar. Méd. 2003;48(2):72-6.

Razafindrabe JA, Rabarijaona M, Rakotoarisoa B, Radriamaro B, Sambany R, Razafindramboah: reasons for hysterectomy in a Gynecology and Obstetrics department. Med. Afr Nre. 2002;49(4):166-8.

Ross RK, Pike MC, Vessey MP. Risk factors for uterine fibroids: reduced risk associated with oral contraceptives. Br Med J. 1986;293:359-62.

Diallo MDD, Bussangu MF. Archive of the Ministry of Planning, National Institute of Statistics, Conakry, Guinea: Demographic and Health Survey (DHS). Guinea, Calvelton, Maryland, USA: INS and ORC Marco; 2012:246-247.

Bezard F. uterine fibromyoma: treatment. Drug treatments for uterine fibroma. Argumentaire. 2001;14:433-45.

Abbara A. Uterine fibromyoma: generalities. J Gynecol Obstet Biol Reprod. 2004;42:716-9.

Zhioua F, Ferciou M, Mouelhi C. Contribution of operative hysteroscopy in the treatment of intrauterine myomas in infertile patients. Magreb Med. 1997;320:34-6.