Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a retrospective study of patients referred with urologic complications following obstetric and gynaecological surgeries. The study took place at the Teaching Clinic of Urology Andrology at CNHU of Cotonou between April 1, 2008 and March 31, 2013. Results: Fortyone patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 years swith range of 20 and 57 years. Twenty-one (51.2%) of them were married. Thirty patients (73.2%) were referred from a non-academichospital, while 7 patients (17.1%) were referred from academic hospital. Caesarean section was the primary gyneco-logical surgery in 22 cases (53.7%) and hysterectomy in 19 cases (46.3%). Clinically, the pre-dominant symptoms were leakage of urine throughout the vagina and obstructive anuria with or without back pain. We found 31 cases of VVF, 5 cases of bilateral ligation of the ureters, 3 cases of unilateral ligation of the ureter, 1 ureteralinjury and 1 uretero-vaginal fistula. These complications were diagnosed postoperatively in 95.1% of cases. Surgeries done included VVF repair in 31 cases (75.6%), unilateral ureteral reimplantation in 4 cases (9.8%), removal of ligation of the ureters in 3 cases (7.3%), bilateral ureteral reimplantation for 2 cases (4.9%) and end-to-end anastomosisin 1 case (2.4%). The postoperative period was uneventful in 29 cases and we observed 7 cases of surgical site infection. The overall success rate was 87.8%. Conclusion: Urological complications following gynecologic surgeries managed at the urologic department of teaching hospital of Coto-nou had an even higher incidence. Early diagnosis especially during the * Corresponding author.
H. P. Pascal et al.
122operative procedure would save the patients' serious complications and open surgery due to the lack of endo-urological facilities. The most important factor in prevention is good knowledge of pelvicanatomy and good knowledge of the surgical techniques of caesarean operation section and trans-abdominal hysterectomy.
We reported a case of an intravesical foreign body in a 16 years old teenager for abortion attempt. During laparotomy for suspected pelvic appendicitis, we incidentally discovered an intravesical foreign body. From this first observation in our urology division, we reviewed the literature on the nature and circumstance of self introduction in bladder of foreign body and their surgical ablation. We emphasized the importance of endoscopy as a support of diagnosis and therapeutic of intravesical foreign body. This observation also highlighted the lack of information in our teenagers about reproductive and sexual health.
We conducted a cross-sectional study between February 1 st , 2012 and September 30, 2012 at Bobo-Dioulasso University Teaching hospital. The target population was all patients seen at the emergency services for acute urinary retention. Among the 155 patients admitted for urological emergencies, 104 (67.1%) had acute urinary retention. The average age of patients was 65 years, ranging from 23 to 89 years and the majority was more than 60 years old (77.8%) and lived in rural areas (64.4%). Prostate tumor pathology and urethral stricture were the most frequent diagnosis, and the renal function was impaired in 33.7% of cases. Urethrovesical drainage, cystocatheterism, and suprapubic cystostomy were the treatment approach in 56.0%, 28.0% and 15.2% of the cases. Acute urinary retention is the most common urological emergency and many complications are associated with urethrovesical sounding. These complications should therefore be prevented by improving acute urinary care.
Aims: The aim of this study was to evaluate the postoperative complications using a standardized classification; modified Clavien's classification. Patients and methods: We have included all patients aged at least 50-years-old on the day of surgery between the 1 st June 2015 and 31 st May 2017 at the urology division of Souro Sanou University Teaching Hospital of Bobo-Dioulasso. Complications reports were performed according to the modified Clavien-Dindo system. Results: Hundred patients (100) presenting a complication after BPH surgery were included in this study in a total of 312 open prostatectomies performed. The postoperative complication rate was 32%. Seventy percent of the patients had at least one complication. Grade I and Grade II complications according to the modified Clavien's classification system were the most represented (87%). Two patients (2) died in the immediate postoperative period (Grade V). The presence of urethral catheter before surgery was identified as a risk factor for complication. A statistically significant difference was found in the group ICC ˃ 2 (Charlson Index of Comorbidity) for age parameter in the occurrence of complication. Conclusions: Open prostatectomy is associated with high morbidity in subjects with urinary catheters prior to surgery. Grade I and Grade II according to the modified Clavien's classification system were the most reported.
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