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RESUMEObjectif: Pr~ciser les diff~rents aspects anatomo-cliniques et th~rapeutiques des accidents de la circoncision re(~us en milieu hospitalier guin(~en. Rdsultats : L'Sge moyen des patients b la rdception dtait de 14,9 + 8,3 ans avec des extr&mes de 10 jours et 32 ans. Le d~lai moyen de consultation en milieu sp6cialis(~ dtait de 16,8 _+ 2,3 mois avec des extr6mes de 2 heures et 37 mois et seuls 29,6 % (n = 13) des patients ont consult6 en milieu sp6cialisd durant la semaine de survenue de I'accident de circoncision. Patients et M~thodeLa circoncision avait ~t~ effectude par un agent paramddical dans 64 % des cas et par un tradipraticien dans 36%. Les Idsions dtaient domin(~es par les fistules ur(~tro-cutan~es (28 cas), les h#morragies p~niennes (10 cas) et les amputations du gland (2 cas). Certains accidents ~taient rares tels que la stdnose du mdat ur~tral et la r(~tention aigu6 d'urine v~sicale.Conclusion : Les accidents de la circoncision sont graves et peuvent engager le pronostic vital. Leur prdvention passe par une meilleure accessibilit~ des enfants aux structures sanitaires qualifi~es, et aussi par la formation du personnel r~alisant cet acte chirurgical.

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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