Cesarean delivery‐related fistulae in the Democratic Republic of Congo

Onsrud, Mathias; Sjøveian, Solbjørg; Mukwege, Denis

doi:10.1016/j.ijgo.2011.01.018

Cited by 59 publications

(72 citation statements)

References 25 publications

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“…Rare causes have been reported in the literature: the fistula may be secondary to vaginal birth on scarred uterus, it can also occur following high vaginal forceps-aided delivery, external cephalic version, curettage or manual removal of the placenta, placenta percreta [8], uterine rupture due to obstructed labor, uterine artery embolization, migration of an intrauterine device secondary to an actinomycotic infection [9], vesical tuberculosis, cervical circling [10], and brachytherapy for cervix carcinoma [11]. But currently, however, there has been an increase in fistulas cases resulting from caesarean section [12]. While most obstetric fistula are vesicovaginal, the vesicouterine type is recognized to occur most often secondary to caesarean delivery [12,13].…”

Section: Discussionmentioning

confidence: 99%

Obstetric Vesicouterine Fistulas: About 26 Cases Managed at Cocody’s University Hospital (Abidjan-Cote d’Ivoire)

Loue¹

2017

JGO

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Abstract:The aim of this work is to recall the etiopathogenic, diagnostic and therapeutic aspects of vesicouterine fistulas. This is a prospective study of 26 cases of obstetric vesicouterine fistula cared for in Cocody University Hospital Center (Abidjan, Cote d'Ivoire) between 07/09/11 and 24/04/2015. Early in the disease, patients were all in reproductive age with a different obstetrical history. The mean duration of the signs before diagnosis was 6 years. Etiologies are largely dominated by caesarean sections (69%) which four iteratives. The classic Youssef's triad syndrome had represented 42.3%. Both hysterography and cystography were sufficient to establish the diagnosis of vesicouterine fistula in all cases. All patient underwent transperitoneal laparotomy repair. Peritoneal patch had been necessary in two cases and in four cases a hysterectomy was performed. Functional outcome was satisfactory. Vesicouterine fistula is a rare obstetric complication and very often iatrogenic. The good prognosis after repairing should not make us forget that this pathology seriously affects the quality of life of the patient. There must be a permanent and quality prevention.

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Section: Discussionmentioning

confidence: 99%

Obstetric Vesicouterine Fistulas: About 26 Cases Managed at Cocody’s University Hospital (Abidjan-Cote d’Ivoire)

Loue¹

2017

JGO

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“…In the literature cesarean section is cited as the main cause of the VUF, because of a lack of vesico uterine detachment. 4,10,11 When performed on a cicatricial uterus, the risk of VUF increases, especially in situations of extreme urgency.…”

Section: Etiopathogenic Characteristicsmentioning

confidence: 99%

Management of Vesicouterine fistulae during fistulae surgical caravan in Cote d'Ivoire

Djanhan¹,

Dia²,

Menin³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: The urogenital fistula (UGF) which designate a solution of continuity between the urinary and genital tracts in women, are divided into several entities of variable gravity. The objective of this study was to describe the epidemiological, clinical and therapeutic characteristics of patients treated for vesicouterine fistula during ‘fistulas surgical caravans’.Methods: This was a prospective and descriptive study on a cohort of 34 patients treated for Vesico-uterine fistulae during ‘‘fistulas surgical caravans '' from 1st January 2012 to 31st December 2016.Results: Vesico uterine fistulae represented 2.1% of all urogenital fistulae treated. At the time of occurrence of fistulas, the average age of the patients stay was 33.3 years, and the majority was not educated (88.2%), lived in rural areas without occupations (73.5%). All the fistulae were secondary to childbirth, the majority of which took place on a scarred uterus (67.6%). And this childbirth responsible for the fistula was done by caesarean section in 97.7% of cases. Then the average duration of the fistula before management was 6 years. Finally, all the patients were operated by the same surgical technique, made by abdominal extra peritoneal transvesical way. The cure rate after this surgical technique was 97.1% (33 patients). The only case of failure required a second operation by another technique which permitted the healing of the patient.Conclusions: The vesicouterine fistulae were rare and the satisfactory results of their management invite us to sustain these surgical caravans and ensure their widespread.

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“…In these circumstances, particularly in uterine rupture,the surgery is performed through tissue planes with compromised blood flow and endometritis, with secondary severe distortion of intra-abdominal pelvic anatomic landmarks. 9 The cause of any subsequent fistula in these circumstances may be due to exacerbation of the edema/ischemia/necrosis cascade due to the introduction of an incision and suture line into the proximal aspects of the damaged organ systems. The fistulae in these cases could be more complex than it may have otherwise.…”

Section: Pathophysiology Of Fistulamentioning

confidence: 99%

Obstetric Fistula in the Developing World: An Agonising Tragedy

Dangal

Thapa²,

Yangzom

et al. 2014

Nepal j. obstet. gynaecol.

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Obstetric fistulae is the most tragic of preventable childbirth complications in the developing world, as affected women are often abandoned by their husbands and family, and forced to live in shame. They occur almost entirely in the developing world and their incidence is poorly studied. Their management requires accurate diagnosis, sufficient pre-operative workup, fine surgery following standard surgical repair steps and principles by skilled surgeons, specialised post-op care, and follow-up. As obstetric fistula is a serious preventable public health issue in developing countries, national and international organizations should launch a campaign to end fistula by increasing the resources and skilled staff available locally to treat obstetric fistula for improving the lives of women currently living with this condition. Moreover, effective preventive strategies for obstetric fistula such as better education to women and provision of improved obstetric care and searching for the best approaches to both prevention and treatment should be the priority. The materials published in PubMed, Lancet, Medline, WHO and Google Scholar web pages from 1990 to 2013 have been utilized to prepare this paper.

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Cesarean delivery‐related fistulae in the Democratic Republic of Congo

Abstract: The data indicate that cesarean delivery-related fistulae are a separate clinical entity. Focus on this condition is important for fistula prevention and provision of adequate obstetric care, particularly for training in surgery and alternative delivery methods.

Cited by 59 publications

References 25 publications

Obstetric Vesicouterine Fistulas: About 26 Cases Managed at Cocody’s University Hospital (Abidjan-Cote d’Ivoire)

Obstetric Vesicouterine Fistulas: About 26 Cases Managed at Cocody’s University Hospital (Abidjan-Cote d’Ivoire)

Management of Vesicouterine fistulae during fistulae surgical caravan in Cote d'Ivoire

Obstetric Fistula in the Developing World: An Agonising Tragedy

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