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Introduction: Urinary incontinence after closure of vesicovaginal fistula is any involuntary loss of urine that a patient complains of. We aim to study the risk factors for urinary incontinence after closure of obstetric vesicovaginal fistula in Guinea in order to develop preventive measures to reduce its incidence. Materials and Methods: This was a retrospective, multiple center cohort of women operated on for obstetric vesicovaginal fistula during a 10-year period. Results: In 1770 vesicovaginal fistulas operated, 1347 were closed. 180 women (13.36%) developed urinary incontinence. After multivariate analysis, the risk factors of urinary incontinence after closure of vesicovaginal fistula were: the patient's age, the anatomical type III, iterative surgical intervention, the brevity of the urethra and decrease in bladder capacity. Conclusion: Urinary incontinence after closure of vesicovaginal fistula is a frequent problem in Guinea, the prevention of which should be integrated into the management of fistulas.

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Objective: To analyze the management of VVF in the Service of Urology-Andrology Obstetrics and Gynecology of the University Hospital in Conakry. Materials and Methods: From January 2012 to December 2013, 152 patients with a mean age of 30 years (14-80 years) were hospitalized in the Departments of Urology-Andrology and Gynecology-Obstetrics of the Conakry University Hospital Center. Clinically fistulas were divided according to the classification of Benchekroun as single, complex and complicated. The fistulas were diagnosed after a minimum period of three months and the results were assessed with a mean follow-up of 7 months (range 3 to 10 months) according to the following criteria: complete healing, intermediate healing and failure. Results: Fistulas occur mainly in young multiparous women. The obstetric etiology was dominant (98%). Clinically, there were 30% simple fistulas, 46% complex fistulas and 24% of complicated fistulas. From a therapeutic standpoint, the treatment consisted of a single fistulorraphie (Chassar Moir) in 82% of cases and a fistulorraphie with interposition of healthy tissue in 18% of cases. After a mean follow-up of 7 months we obtained a healing in 62% of cases, a failure in 31% of cases and the results were intermediate in 7% of cases. Conclusion: It appears that the VVF represents a public health concern in Guinea and surgical treatment is technical difficult due to the higher frequency of complex fistulas.

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The objective of the study was to report the results of the surgery of the Vesico-vaginal fistula (VVF) transection types at CHU Conakry. Methods: This was a prospective descriptive study that focused on 64 patients operated for VVF transection type at the Urology department of CHU Conakry between January 2013 and December 2015. Four types of transection were defined according to the state of the urethra and vagina, the size of the fistula, the peri-fistulous tissue and associated lesions. The variables studied were the proportion of transection, age, the type of transection, the number of previous cures, the operative technique, the complications and the results after a follow-up of 3 months. Results: Transection accounted for 47.05% of the obstetric fistulas. The average age was 25.18 years old (14-43 years old). This was a Type I transection (11 cases), type II (27 cases), type III (19 cases) and type IV (7 cases). The surgical approach was vaginal in 64 cases. Fistulorraphy with a confection of a new cervix and cervico-urethral anastomosis was conducted in 19 patients, combined with bladder flap urethroplasty (30 patients) or vaginal flap (15 others). We recorded healing in 37 cases. Conclusion: Transection type VVF is a severe VVF. The preferential surgical approach was vaginal. Technical difficulties were related to associate lesions and the continence system affected.

Pour citer cet article : Diallo AB, et al. La varicocèle de l'adulte: aspects anatomo-cliniques et resultats therapeutiques au service d'urologie-andrologie du CHU de Conakry, Guinee. Afr J Urol (2015), http://dx.Reçu le 21 octobre 2014; reçu sous la forme révisée le 9 janvier 2015; accepté le 11 février 2015 MOTS CLÉS Varicocèle; spermogramme; chirurgie; fertilité Résumé Objectif: Décrire les aspects anatomo-cliniques et évaluer les résultats thérapeutiques de la varicocèle au service d'urologie-andrologie du CHU de Conakry. Patients et Méthode: Il s'agit d'une étude prospective de type descriptif portant sur un échantillonnage exhaustif de 119 cas colligés dans le service d'Urologie-Andrologie du CHU de Conakry durant une période d'un an. Sur le plan clinique les varicocèles ont été classées en 4 grades selon Dubin et Amelar. Tous les patients avaient bénéficié d'au moins un spermogramme en pré et post opératoire. Résultats: L'âge moyen des patients était de 38 ans avec des extrêmes de 22 et 53 ans. La varicocèle était découverte dans 80,7% (n = 96) des cas au cours d'une consultation pour infertilité conjugale. La varicocèle était gauche dans 84,9% (n = 101) des cas et bilatérale dans 15,1% (n= 18) des cas. Le spermogramme préopératoire était normal dans 5% des cas et l'oligo-asthéno-tératozoospermie avec 46,2% (n = 55) des cas était l'anomalie la plus retrouvée. Tous les patients ont bénéficié d'une cure chirurgicale selon la technique d'Ivanissevitch. Après un suivi moyen de 17 mois pour 113 patients, une amélioration notable de la qualité du sperme a été notée chez 67 patients avec une normalization du spermogramme chez 33 d'entre eux. Par contre aucune amélioration n'a été notée chez 6 des 8 patients azoospermes. Quarante-deux grossesses spontanées soit 35.3% ont été enregistrées chez les conjointes des patients durant le suivi. Pour citer cet article : Diallo AB, et al. La varicocèle de l'adulte: aspects anatomo-cliniques et resultats therapeutiques au service d'urologie-andrologie du CHU de Conakry, Guinee. Afr J Urol (2015), http://dx.AFJU-181; No. of Pages 5 2 A.B. Diallo et al.Conclusion: La varicocèle est une pathologie fréquente dans notre pratique quotidienne; l'infertilité du couple en est la forme de découverte la plus fréquente. Le profil spermatique est celui d'une oligoasthéno-tératozoospermie. La cure chirurgicale améliore de façon significative la fertilité des patients hypofertiles.Adult varicocele: anatomical, clinical aspects and therapeutic results in the service of urology-andrology at Conakry teaching hospital, Guinea AbstractObjective: To describe the clinical aspects of varicocele and to evaluate the outcome of its treatment at the Hospital over a one-year period. Clinically, the varicoceles were classified into four grades according to the classification of Dubin and Amelar. All patients received at least one semen analysis pre-and postoperatively.Results: The mean age of the patients was 38 (range 22-53) years. In 80.7% (n = 96) of the cases the varicocele was detected in the cours...

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