14 Cases of Uretero-Vaginal Fistulain the Provincial Hospital of Abeche, Chad

Abstract

Introduction: Urethro-Vaginal Fistula (UVF) is a communication between the ureter and the vagina. It is generally about an iatrogenic lesion happening in the decline of gynaeco-obstetrical pelvic surgery. Its main manifestation is the permanent leak of urines through the vagina with the notion of normal micturition conservation except in the case of bilateral lesion. The objective of this study was to describe the clinical, diagnostic, and therapeutic aspects. Patients et methods:It was about a retrospective and descriptive study focusing on the cases of Urethro-Vaginal Fistulas diagnosed and taken care of in the Provincial Hospital of Abeche from January 2011 to December 2016.The studied variables were sociodemographic, clinical, para clinical, therapeutic, and evolutionary. Results: During the study period, 14 cases of UVF have been diagnosed and treated.The average age of patients was 25.The average gestation is 3 and that of parity 2. The aetiology of the UVF: hysterectomy(n=5 that is 35,71%) and the caesarean section (n=9 that is 64,29%).The diagnosis was kept after a clinical and para clinical check-up mainly the examination through speculum, the examination through the blue of methylene, and the UIVwith negative profile photos. The ECBU has been positive in 4 cases (E. Coli), the presence of creatine was normal. The treatment consisted in urethro-vesicalre implantion with an anti-reflux device. The immediate post operating results were simple in 12 cases and the 2 other cases were marked by an E. Coli infection. Conclusion: UVF is a rare complication in gynaeco-obstetrical surgery. The reference treatment is the urethro-vesicalre implantation respecting the anti-reflux system.