TITLE:
Results of the Management of Urogenital Fistulae from Community Caravans
AUTHORS:
Eric Bohoussou, Jean Marc Dia, Gerard Okon, Lydie Djanhan, Bilé Kouamé, Yao Djanhan, Gabriel Gnanazan, Serges Boni
KEYWORDS:
Urogenital Fistulas, Epidemiology, Diagnosis, Treatment
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.8,
August
3,
2017
ABSTRACT: 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.