[Urogenital fistulas: etiopathogenic and therapeutic aspects at the University Hospital Center of Brazzaville]. / Les fistules urogenitales: aspects ethiopathogeniques et therapeutiques au CHU du Brazzaville.

ABSTRACT

INTRODUCTION: The urogenital fistulas continue to be a dangerous complication of the childbirths dystociques in Africa and especially to Congo. OBJECTIVES: To analyze the étiopathogénic and therapeutic aspects of the urogenital fistulas in order to suggest preventive measures. SICK AND METHODS: It is about a retrospective survey achieved in the service of urology of the univertery hospital center of Brazzaville of January 2001 to December 2005 concerning 34 patients hospitalized for urogenital fistulas. The étiopathogéniques and therapeutic aspects have been analyzed. RESULTS: The urogenital fistulas represent about 2,7% of the hospitalizations in urology. The middle age is of 31 years (17 - 65 years). 28 (82%) are of obstetric origin with 11 Caesareans and 17 childbirths dystociques. 6 are especially of surgical origin after hysterectomy. 28 patients have been operated among which 2 have been taken. The different surgical techniques were the following 20 ways transvésicales, 3 Chassar Moirs, 2 LEGUEU, 3 Martius and 2 vaginal ways with Picot Couvelaire. The anatomical shapes were 29 fistulas vésicovaginales, 1 vésico uterine, 3 vesico vaginorectal and 1 urétérovaginale. After surgery, we got 25 anatomical closings of which 1 with incontinence. 3 recidivisms have been observed 2 have been reoperate of which 1 success and 1 failure. The 3rd being lost of view. To the total we got 25 successes (89,2%). CONCLUSION: The urogenital fistulas remain frequent with a predominance of the obstetric reasons. The recidivisms are possible from where the necessity of a mastery of the surgical techniques.