Early primary endoscopic realignment of complete traumatic rupture of the posterior urethra is a simple, rapid and non-traumatic technique. We have recently treated 5 patients in this manner. All are continent and 4 are potent. Four patients were followed up for 1 year. One patient required no further management and had excellent urinary flow rates. The other 3 developed short secondary strictures which were managed successfully by 1 or 2 internal urethrotomies.
Objective: To analyze the management of VVF in the Service of Urology-Andrology Obstetrics and Gynecology of the University Hospital in Conakry. Materials and Methods: From January 2012 to December 2013, 152 patients with a mean age of 30 years (14-80 years) were hospitalized in the Departments of Urology-Andrology and Gynecology-Obstetrics of the Conakry University Hospital Center. Clinically fistulas were divided according to the classification of Benchekroun as single, complex and complicated. The fistulas were diagnosed after a minimum period of three months and the results were assessed with a mean follow-up of 7 months (range 3 to 10 months) according to the following criteria: complete healing, intermediate healing and failure. Results: Fistulas occur mainly in young multiparous women. The obstetric etiology was dominant (98%). Clinically, there were 30% simple fistulas, 46% complex fistulas and 24% of complicated fistulas. From a therapeutic standpoint, the treatment consisted of a single fistulorraphie (Chassar Moir) in 82% of cases and a fistulorraphie with interposition of healthy tissue in 18% of cases. After a mean follow-up of 7 months we obtained a healing in 62% of cases, a failure in 31% of cases and the results were intermediate in 7% of cases. Conclusion: It appears that the VVF represents a public health concern in Guinea and surgical treatment is technical difficult due to the higher frequency of complex fistulas.
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