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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 Côte d'Ivoire. Various anatomoclinical varieties have been identified and treated with satisfactory results in poorly equipped local structures.

Introduction La planification familiale est une stratégie à haut impacts pour la réduction de la mortalité maternelle et pour la prévention de la transmission mère-enfant du VIH. L'objectif de cette étude était de décrire les pratiques contraceptives des femmes infectées par le VIH suivies en ambulatoire au CHU de Treichville Méthodes Une enquête transversale descriptive a été réalisée dans les unités de soins ambulatoires aux personnes vivant avec le VIH du CHU de Treichville du 1 er avril au 30 juin 2016. Durant cette période, toutes les patientes VIH positives en âge de procréer, fréquentant les services de gynécologie-obstétrique, pneumo-phtisiologie, dermatovénérologie et médecine interne ont été invitées à renseigner un questionnaire standardisé portant sur les caractéristiques sociodémographiques, médicaux et les pratiques contraceptives Résultats Au total, 283 femmes ont accepté de participer à l'étude, l'âge médian était de 36 ans avec une parité moyenne de 1,7. Les patientes étaient nullipares dans seulement 22,3% des cas et vivaient en couple dans 54,8% des cas. Elles n'avaient pas d'enfant avec le conjoint actuel dans 68,2% des cas. Le conjoint était informé du statut VIH dans 51,6% des cas. Elles étaient sous traitement antirétroviral dans 92,9% des cas avec une médiane de CD4 de 382 éléments/ml. La majorité des patientes (62,9%) avaient déclaré utiliser une méthode contraceptive moderne. Elles utilisaient surtout les progestatifs injectables (45,5%) et l'implant (32,6%). La pratique de la double protection n'a été signalé par seulement 17,4% d'entre-elles. Le niveau scolaire secondaire et supérieur (OR=2,23 [1,35-3,69], p=0,01), la multiparité (OR=1,84 [1,11-3,06], p=,002) et la révélation du statut VIH au conjoint (OR=1,86 [1,14-3,03], p < 0,01) étaient les facteurs significativement associés à l'utilisation de la contraception Conclusion Les pratiques contraceptives des femmes infectées par le VIH dans notre expérience restent globalement décevantes. Il faut développer des stratégies visant à améliorer l'intégration de la planification familiale dans la prise en charge les femmes infectées par le VIH.

Background Immediate postpartum intrauterine device (PPIUD) is a good solution for reducing low contraceptive coverage in developing countries. However, its use in HIV-infected women is poorly documented. The objective of this study was to assess whether the risk of PPIUD complications was higher in HIV-infected women. Methods A retrospective cohort study compared 64 HIV-infected women to 128 HIV-negative women who had had a PPIUD at the University Hospital of Treichville between January 2016 and March 2017, with a match at the insertion time of the PPIUD. The complications considered were pelvic pain, metrorrhagia and genital infections. Chi-squared test and relative risk were used to investigate the association between HIV infection and PPIUD complications. Results HIV-infected patients had an average age of 33.1 years, and 85.9% of them were on antiretroviral therapy. PPIUD was inserted during cesarean section in 66.1% of cases. There was no significant association between HIV infection and PPIUD complications (RR = 0.7, 95% CI [0.4-1.3], p = 0.3). The risk of genital infections was not increased in HIV-infected women (RR = 0.6 [0.1-2.7], p = 0.7). Conclusion HIV infection does not increase the risk of PPIUD complications. This effective contraceptive strategy can be offered to HIV-infected women. It is therefore necessary to strengthen the training of maternity staff in the installation of PPIUD.

Concomitant radiochemotherapy is the therapeutic standard for locally advanced (Ib2 to IVa stage FIGO) cervical cancer. In the absence of a radiotherapy in many of our Sub-Saharan African countries, surgical resection is the only therapeutic method available in hopes of achieving a definite cure. However, criteria for curative surgery are not always met due to preoperative understaging of most of our patients. In addition to socioeconomic factors, the causes for understaging are numerous. These include the lack of personnel or underqualified personnel and the absence of complete workup to assess the resectability of the tumor, but above all the lack of decision-making through multidisciplinary consultation meetings. This study makes a plea in order to provide our hospitals with qualified personnel and adequate technical platform to allow efficient management of our patients with cervical cancer.

Objectives: This study aimed to describe the epidemiological characteristics of metastatic relapse in breast cancer at the University and Hospital Center of Treichville. Methodology: This is a cohort and retrospective study conducted from January 2000 to December 2015 on 178 patients with metastaticrelapse in breast cancer. Results: The prevalence of metastatic relapses was 49% and the patients had an average age of 53.4 years and among them, 91.6% received school education and 88.2% did not have a high socioeconomic level. The majority of initial tumors were in Stage III (47.8%), SBR III (47.2%), High Ki 67 (46.5%), Negative RH (79.3%), and HER2 negative (58%). Metastases were generally unique (62.9%), dominated by bone sites (36.6%), with an average occurrencedelay of 2.4 years. After the occurrence of metastases, the cumulative survival rate was 5% at 3 years, and nil at 5 years. Conclusion: Metastatic relapses were common with poor prognosis.

Objective: To report the experience of Gynecology Department of the University Hospital of Treichville in the management of the inflammatory breast cancers. Methodology: We conducted a retrospective and descriptive study on cases of the inflammatory breast cancers managed in the Gynecology Department of the University Hospital of Treichville, from January 2011 to December 2015. Results: We collected 44 cases of inflammatory breast cancer representing 17.9% of all breast cancers. The average age of patients was 46.5 years (32 -70 years) and among them, the majority had inadequate socioeconomic level (90.9%). The risk factor for cancer found in the majority of patients was the age of first menstrual periods before the age of 12 years (52.3%). The average consultation time was long (10 months) and several patients had extensive inflammatory signs (38.6%), with lymph node involvement (84.1%) and metastases (36.4%). At the histological analysis, the most common type was invasive ductal carcinoma (81.8%), SBR grade III (54.5%). Regarding treatment, mastectomy according to Patey associated with a chemotherapy was performed in 22.7% cases. The evolution has been marked by an overall 5-year survival of 20%. Conclusion: The management of inflammatory breast cancers was late and incomplete in our service making poor prognosis.