Introduction: Urogenital fistula is the existence of an abnormal pathway between a urinary organ and a genital organ. It is a public health problem because of its frequency and social aspect. The aim of this study was to analyse the management of urogenital fistulas by the upper route at the National Fistula Treatment Centre in N’Djamena. Material and Methods: This was a 10-year retrospective descriptive and analytical study from May 2011 to April 2021. The records of all patients who had received fistula treatment during this period were identified and analysed. Results: During the study period 2369 patients were managed for cure of urogenital fistula including 84 by the upper route, i.e. 3.5%. The mean age was 28.5 ± 8.13 years. Loss of urine was the most common reason for consultation (71.4%). Primigravida were represented in 50% (n = 42). The average gestational age was 3.2 ± 2.8 with extremes of 0 to 9 pregnancies. Obstetric aetiology was the most common (92.8%). Ureterovaginal fistulas were the most common anatomoclinical type (36.9%). Uretero-vesical reimplantation was the main surgical procedure (41.7%). Late postoperative follow-up was successful in 85.7% of cases. Conclusion: Urogenital fistulas are common in our practice. The only way to combat this scourge is through prevention through information, education and communication.
References
[1]
Hilton, P. (2003) Vesico-Vaginal Fistulas in Developing Countries. International Journal of Gynecology & Obstetrics, 82, 285-295. https://doi.org/10.1016/S0020-7292(03)00222-4
[2]
Huang, W., Zinmam, L.N. and Bihile, W. (2002) Surgical Repair of Vesico-Vaginal Fistulas. Urologic Clinics of North America, 29, 709-723. https://doi.org/10.1016/S0094-0143(02)00064-2
[3]
Langkilde, N.C., Pless, T.K., Lundbeck, F. and Nerstrom, B. (1999) Surgical Repair of Vesicovaginal Fistulae: A Ten-Year Retrospective Study. Scandinavian Journal of Urology and Nephrology, 33, 100-103. https://doi.org/10.1080/003655999750016069
[4]
Hillary, C.J. and Chapple, C.R. (2018) The Choice of Surgical Approach in the Treatment of Vesico-Vaginal Fistulae. Asian Journal of Urology, 5, 155-159. https://doi.org/10.1016/j.ajur.2018.01.002
[5]
Tebeu, P.M., Fomulu, J.N., Khaddaj, S., de Bernis, L., Delvaux, T. and Rochat, C.H. (2011) Risk Factors for Obstetric Fistula: A Clinical Review. International Urogynecology Journal, 23, 387-394. https://doi.org/10.1007/s00192-011-1622-x
[6]
Sanda, G., Chipkao, R., Harison, A., Soumana, A. and Tassiou, E.M. (2016) Les fistules urogénitales iatrogènes A propos de 62 cas et revue de la littérature. African Journal of Urology, 22, 55-60. https://doi.org/10.1016/j.afju.2015.09.007
[7]
Kpatcha, T.M., Wangala, P., Botcho, G., Tchandana, M., Nembuzu, D., Aboubakari, A.S., et al. (2020) Profil épidémiologique, anatomocliniques et thérapeutique des fistules urogénitales et rectovaginales au Togo. Progrès en urologie, 30, 597-603. https://doi.org/10.1016/j.purol.2020.06.008
[8]
Fasnewindé, A., Stéphane, D., Ahmida, N., Boureima, O., Moussa, K., Adama, O., et al. (2020) Characteristics of Obstetric and Iatrogenic Urogenital Fistula in Burkina Faso: A Cross-Sectionalstudy. Advances in Urology, 6, 46-47.
[9]
Lamine, N., Mahamat, A., Awa, M., Oumou, M., Ndoye, M., Jalloh, M., et al. (2016) Les fistules vésico-vaginales obstétricale en Guinée-Bissau. Aspects épidémiologiques et thérapeutiques. Revue Africaine d’Urologie et d’andrologie, 8, 12-18.
[10]
Vadandi, V., Rimtebaye, K., Choua, O., Mahamat, A. and Tebeu, P.M. (2019) Aspects cliniques et thérapeutiques des fistules vésico-vaginales obstétricales à l’hôpital régional d’Abéché. Tchad. Uro Andro, 3, 11-14.
[11]
Kimassoum, R., Franklin, D.S., Arya, Z.A.T. and Kaboro, M. (2016) Evaluation du traitement de l’incontinence urinaire après cure de fistule obstétricale. Revue Africaine d’Urologie et d’Andrologie, 1, 242 p.
[12]
Konan, P.G., Fofana, A., Kramo, N.F., Vodi, C.C., Gowe, E.E., Dekou, A.H., et al. (2015) les fistules urogénitales dans le service d’urologie du CHU de Cocody. Aspect évolutif de 1990-2000 et 2000-2010. Revue Africaine d’Urologie et d’andrologie, 1, 38-79.
[13]
Diallo, A.B., Sy, T., Bah, M.D., Diallo, T.M.O., Barry, M.S., Bah, I., et al. (2016) Fistules vésico-vaginales obstétricales en Guinée: analyse des données de trois les sites de prise en charge de l’ONG Engender Health. Progrès en urologie, 26, 145-151. https://doi.org/10.1016/j.purol.2016.01.006
[14]
Fofana, A., Coulibaly, N., Tuo, L., Sekou, M. and Yao, K. (2021) Les résultats du traitement chirurgical des fistules urogénitales post hystérectomies au service d’urologie du CHU de Treichville. Revue internationale des sciences d’Abidjan, 23, 114-119.
[15]
Komanda, L., Maindo, A.M., Lula, A. and Okenge, L. (2014) Fistules urogénitales: étude épidémiologique et clinique dans deux hôpitaux généraux du district de la Tshopo, Kisangani—RDC. Kismed, 5, 77-81.
[16]
Diallo, A., Zakou, A., Pereira, E., Jalloh, M., Ndoye, M., Niang, L., et al. (2019) Prise en charge des fistules urogénitales au service d’Urologie de l’Hôpital Général de Grand Yoff (Dakar). Uro Andro, 2, 24-28.
