Les fistules uro-génitales iatrogènes: À propos de 62 cas et revue de la littérature

Sanda, G.; Chipkao, R.; Adamou, Harissou; Soumana, A.; Tassiou, E.M.

doi:10.1016/j.afju.2015.09.007

Cited by 12 publications

(23 citation statements)

References 30 publications

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“…Uro genital and uro digestive fistulas were the second type of complication in our study. They were present in the case series published by Sanda et al, in Niger [13] and Kpatcha et al [7] in Senegal, who noted that the entire section of the ureter, bladder and vaginal fistulas represented 51.72% of complications (n = 15).…”

Section: Discussionmentioning

confidence: 99%

“…The endoscopic and laparoscopic approaches were practiced by some teams The uro genital fistulas were the second of surgical repairs fistulorraphie with generally favorable results: 75% for Diallo [6], 90% for Bouya [5], 98.3% for Sanda [13] and 100% for Kpatcha [7]. Surgical treatment was performed by general surgeons, urologists or gynecologists [2] [7] [8] [12].…”

Section: Discussionmentioning

confidence: 99%

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Urological Complications of Gynecological and Obstetric Interventions: Management at the Ignace Deen National Hospital—University Hospital of Conakry (Guinea)

Diallo¹,

Diallo²,

Raphiou³

et al. 2017

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Introduction: pelvic abdominal surgery may be associated with urological complications requiring reoperation. The aim of this study was to evaluate the urological surgical complications of gynecological and obstetric procedures conducted at the Ignace Deen University Hospital of Conakry in Guinea. Methodology: This was a retrospective, cross-sectional, descriptive study of ten years, from 1 January 2006 to 21 December 2015. Results: Of 14,500 patients hospitalized in the maternity ward during the study period, 31 patients had secondary urological complications during gynecological or obstetric intervention 0.2%). The mean age of the patients was 34.77 years (range: 17 to 58 years). The mean duration of hospital stay was 13.29 days (range: 3 to 28 days). Signs of complication were mainly postoperative abdominal pain (64%, n = 20), vaginal urine leakage (19.35%, n = 6) and vaginal bleeding (9.68% n = 3). The diagnosis was mainly confirmed by ultrasound (70.45%, n = 31). The lesions were primarily ureteric (77.42%, n = 17) or on the urethral wounds (8.12%, n = 12). Urological complications mostly occurred during hysterectomy (41.94%, n = 13) and caesarean section (32.26%, n = 10). Repair procedures included uretero-vesical reimplantation (58.06%, n = 18), vesico-vaginal fistuloraphy (22.58%, n = 7), vesico-uterine fistuloraphy (12.90%, n = 4) and temporary ureterostomy (6.45%, n = 2). Treatment were successful in 28 patients (90.32%) and a lethality of 9.68% (n = 3) was recorded. Conclusion: Urological surgical complications of obstetric gynecological surgeries were

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Urological Complications of Gynecological and Obstetric Interventions: Management at the Ignace Deen National Hospital—University Hospital of Conakry (Guinea)

Diallo¹,

Diallo²,

Raphiou³

et al. 2017

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“…With funding from the United States Agency for International Development (USAID), EngenderHealth’s multi-country Fistula Care+ Project found that iatrogenic injury accounted for 18% of the fistulas where the surgeon noted etiology [ 4 ]. In Niger 9.9% of 624 fistulas were iatrogenic, [ 6 ] while in the D.R. Congo 19.4% of 1984 fistulas were non-obstetric, with iatrogenic fistulas accounting for an unspecified share [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic genito-urinary fistula following cesarean birth in nine sub-Saharan African countries: a retrospective review

Ngongo

Raassen

Mahendeka

et al. 2022

BMC Pregnancy Childbirth

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Background Genito-urinary fistulas may occur as complications of obstetric surgery. Location and circumstances can indicate iatrogenic origin as opposed to pressure necrosis following prolonged, obstructed labor. Methods This retrospective review focuses on 787 women with iatrogenic genito-urinary fistulas among 2942 women who developed fistulas after cesarean birth between 1994 and 2017. They are a subset of 5469 women who sought obstetric fistula repair between 1994 and 2017 in Tanzania, Uganda, Kenya, Malawi, Rwanda, Somalia, South Sudan, Zambia, and Ethiopia. We compared genito-urinary fistula classifications following vaginal birth to classifications following cesarean birth. We assessed whether and how the proportion of iatrogenic genito-urinary fistula was changing over time among women with fistula, comparing women with iatrogenic fistulas to women with fistulas attributable to pressure necrosis. We used mixed effects logistic regression to model the rise in iatrogenic fistula among births resulting in fistula and specifically among cesarean births resulting in fistula. Results Over one-quarter of women with fistula following cesarean birth (26.8%, 787/2942) had an injury caused by surgery rather than pressure necrosis due to prolonged, obstructed labor. Controlling for age, parity, and previous abdominal surgery, the odds of iatrogenic origin nearly doubled over time among all births resulting in fistula (aOR 1.94; 95% CI 1.48–2.54) and rose by 37% among cesarean births resulting in fistula (aOR 1.37; 95% CI 1.02–1.83). In Kenya and Rwanda the rise of iatrogenic injury outpaced the increasing frequency of cesarean birth. Conclusions Despite the strong association between obstetric fistula and prolonged, obstructed labor, more than a quarter of women with fistula after cesarean birth had injuries due to surgical complications rather than pressure necrosis. Risks of iatrogenic fistula during cesarean birth reinforce the importance of appropriate labor management and cesarean decision-making. Rising numbers of iatrogenic fistulas signal a quality crisis in emergency obstetric care. Unaddressed, the impact of this problem will grow as cesarean births become more common.

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“…Location and circumstances can indicate that a fistula is iatrogenic rather than attributable to pressure necrosis [7,11]. Evidence has been mounting about the proportion of iatrogenic fistula amongst repaired fistulas [18][19][20][21]. In a separate analysis we reported that 26.8% (787/2,942) of women with fistula after cesarean section have injuries caused by surgery rather than pressure necrosis from prolonged, obstructed labor [7].…”

Section: Discussionmentioning

confidence: 94%

A retrospective review of genital fistula occurrence in nine African countries

Ngongo

Raassen²,

Mahendeka

et al. 2022

BMC Pregnancy Childbirth

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Background Female genital fistulas are abnormal communications that lead to urinary and/or fecal incontinence. This analysis compares the characteristics of women with fistulas to understand how countries differ from one another in the circumstances of genital fistula development. Methods This retrospective records review evaluated demographics and circumstances of fistula development for 6,787 women who sought fistula treatment between 1994 and 2017 in Tanzania, Uganda, Kenya, Malawi, Rwanda, Somalia, South Sudan, Zambia, and Ethiopia. Results Most women developed fistula during childbirth, whether vaginal (3,234/6,787, 47.6%) or by cesarean section (3,262/6,787, 48.1%). Others had fistulas attributable to gynecological surgery (215/6,787, 3.2%) or rare causes (76/6,787, 1.1%). Somalia, South Sudan, and Ethiopia had comparatively high proportions following vaginal birth and birth at home, where access to care was extremely difficult. Fistulas with live births were most common in Kenya, Malawi, Rwanda, Uganda, Tanzania, and Zambia, indicating more easily accessible care. Conclusions Characteristics of women who develop genital fistula point to geographic differences in obstetric care. Access to care remains a clear challenge in South Sudan, Somalia, and Ethiopia. Higher proportions of fistula after cesarean birth and gynecological surgery in Kenya, Malawi, Rwanda, Uganda, Tanzania, and Zambia signal potential progress in obstetric fistula prevention while compelling attention to surgical safety and quality of care.

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Les fistules uro-génitales iatrogènes: À propos de 62 cas et revue de la littérature

Cited by 12 publications

References 30 publications

Urological Complications of Gynecological and Obstetric Interventions: Management at the Ignace Deen National Hospital—University Hospital of Conakry (Guinea)

Urological Complications of Gynecological and Obstetric Interventions: Management at the Ignace Deen National Hospital—University Hospital of Conakry (Guinea)

Iatrogenic genito-urinary fistula following cesarean birth in nine sub-Saharan African countries: a retrospective review

A retrospective review of genital fistula occurrence in nine African countries

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