Vesicovaginal Fistulas: Anatomical Clinical and Surgical Aspects in the Conakry University Hospital Center

Abstract

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.

Epidemiology and Sensitivity to Antibiotics of Uropathogenic Bacteria in Patients at the CHU Ignace Deen National Hospital in Conakry, Guinea

“…While the majority of patients came from Lower Guinea, i.e. 67.9%, Upper Guinea and Forest Guinea were poorly represented with 7.8 and 2.2% respectively [14].…”

Does freeze dried amnion useful as scaffold for mesenchymal stem cell for repair of vesicovaginal fistula? An overview of proliferative and remodeling phase in the wound healing process

“…Successful closure of a vesicovaginal fistula requires accurate and timely repair with a procedure that utilizes basic surgical principles [3]. The World Health Organization estimates that approximately 3 million women in the world experience fistula due to obstetrics, with 50,000 to 130,000 new cases of fistula per year [4]. In the USA, the incidence of fistula is < 0.5% after simple hysterectomy and 10% after radical hysterectomy.…”

New vesicovaginal fistula formation in a rabbit model

“…1 In the developed countries, the most common etiologies of VVF include gynecological surgery injuries, pelvic surgery or radiotherapy lesions, whereas, in developing countries, obstetric causes are the predominant etiology due to prolonged obstructed labor in patients with poor access to medical care. 2,3 The WHO has estimated that about 3 million women have obstetric fistula worldwide, with 50 -130,000 new fistulas reported each year. 2 Rates of failure after bladder fistula repairs depend on the type and severity of the fistula, patient complexity, nature and cause of the fistula, and length of follow-up.…”

“…2,3 The WHO has estimated that about 3 million women have obstetric fistula worldwide, with 50 -130,000 new fistulas reported each year. 2 Rates of failure after bladder fistula repairs depend on the type and severity of the fistula, patient complexity, nature and cause of the fistula, and length of follow-up. Surgery is a standard treatment of vesicovaginal fistula which has a success rate of 85-95% in the first surgery and will decrease in recurrent surgery.…”