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SAS Journal of Surgery | Volume-7 | Issue-06
Iatrogenic Urological Lesions Secondary to Gyneco-Obstetric Surgery
Traoré S., Traoré S.A., Sylla M., Dembélé O., Coulibaly M., Cissouma A., Cissé A., Touré O., Kanté M., Diassana M., Traoré B., Traoré Y., Diallo A., Diassana M.
Published: June 30, 2021 | 136 141
DOI: 10.36347/sasjs.2021.v07i06.021
Pages: 346-349
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Abstract
Introduction: The aim of this study was to analyze the epidemioclinical aspects of iatrogenic urological lesions, to describe the anatomical lesions and to establish a link between surgery and these lesions. Materials and methods: Descriptive and retrospective study carried out in the urology department of Sikasso hospital from January 2016 to December 2018. Results: In total, 26 patients suffering from iatrogenic urological lesions secondary to gyneco-obstetric surgery were recruited, ie 2.86% of our activities and 17.74% of female urogenital lesions. Average age: 31, 88 ± 11, 54 years old; Average age at 1st marriage: 15.00 ± 1.87 (12 - 20). Almost all of our patient was out of school, homemaker, in unpaid jobs and 83.33% from rural Sikasso. Seventeen patients (65, 38%) were 1.55 m shorter and of these 25% had not received antennal care. Labor stagnation (mean duration: 47, 22 ± 20, 48 hours) was the main indication with 90.47% of stillbirths. The main complaint (92, 30%) of our patients was leakage of urine, followed by abdominal-lumbar pain and abdominal distension associated with anuria. Urogenital fistulas (91.66%); urinary tract infection (20.83%) and acute renal failure 11.53% were common complications. The most common causal operation (76.91%) was cesarean section, often performed by general practitioners. The bladder was more frequently (65, 40%) affected by these injuries than the ureter (34, 60%). Regarding the surgical approach, an open transvesical fistulorrhaphy in two planes or a vesicoureteric reimplantation was performed. The result was excellent in 88, 46% of cases and bad in 11 and 53%. Conclusions: Iatrogenic urologic complications of gyneco-obstetric surgery were not uncommon. Early diagnosis and appropriate management could improve its prognosis. The preventive measures are based on the promotion of girls' education and socio-economic life, good antennal care and the continuing training of health care providers in charge of managing obstetric