Obstetric vesico-uterine fistula in nine reference hospitals in the Democratic Republic of the Congo: epidemiological, clinical, and therapeutic aspects

2024-09-16 | Télécharger

BACKGROUND :

Female urogenital fistulas are pathological communica- tions between the urinary tract and the genital organs. Among these fistulas is the vesico-uterine fistula, an anatomoclinical entity in which the bladder communi- cates with the uterus. The most frequent causes of uro- genital fistulas are obstetrical or surgical. Also, they can be caused by tumors or radiation necrosis. In the literature on obstetric fistulas in the DRC, vesico-vaginal fistulas are the most common anatomoclinical entity of urogenital fistulas.

Obstetric vesico-uterine fistula is relatively common in the DRC, certainly due to the increasing number of cae- sarean deliveries. Patients are predominantly primipa- rous, aged between 20 and 29, living in rural areas and with a with limited formal education. Cesarean section is the main cause of this anatomoclinical entity of obstet- ric urogenital fistula. This fistula is often isolated, single, but its association with ureterovaginal fistula is the most frequent. Fibrosis is absent in a third of cases. Abdomi- nal approach for repair of this fistula is highly effective, with good results in almost all cases. Accessibility to good Cesarean sections and ongoing training for doctors working mainly in rural areas would help reduce the fre- quency of OVUFs in the DRC.