<p> <b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:""><span style="font-family:Verdana;">Female gen...<p> <b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:""><span style="font-family:Verdana;">Female genital fistula (FGF), remains a world concern, especially in low developed country. Obstructive (blocked) delivery labor is his principal cause, sometimes by pelvic surgery (urogenital or obstetrical, rectal) more rarely by congenital urogenital malformation, excision, pelvic neoplasm, pelvic radiotherapy. We were interested in iatrogenic FGF treated in the special referral fistula center. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">We report 35 cases of iatrogenic female genital fistula. Are included only cases by urogenital surgery, excision in the National Referal Center of Obstetrical Fistula. Were not included cases happened by over 12 hours blocked delivery labor, caustic destruction, pelvic cancer pelvic infection and those with incomplete file. The epidemiologic, clinical and therapeutic information were studied. All ethical protocols were respected. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">CNRFO recorded 743 cases of female genital fistula from May 23 2013 to May 23 May 2018 within 35 iatrogenic cases (4.71%). Patients were 19 - 29 years old (42.85%), average age 35 years old, extremes 19 - 60 years, without occupation (82.86), grand multiparous 48.57%, with a mean of 4 previous deliveries. The principal constancies were hysterectomies 71.43%, caesarean section 17.14%, genital excision 11.42%, and cystocele cure 11.42%. The anatomical finds were soft vagina tissue 97.14% uretero-vaginal fistula 45.71% (2 cases post Caesarean, 14 cases post hysterectomy), vesico-vaginal 31.43% (all post hysterectomy), ureteral 11.42% (all post caesarean), 1 vesico-uterine 5.71% (case post caesarean), 1 case after a cystocele cure, 2 uretro-vaginal 11.42% secondary of genital excision. Treatment was ureteral reimplantation (18/31) cases by abdominal way, fistulorraphy (12/31) and 1uretroplasty by vaginal, 4 cases treated with transurethral bladder probe. 30 were cured by fistulas surgery, 1 urinary tress incontinency and 1 not closed, and 4 of transurethral bladder probe were cured. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The female genital fistula is sometimes the consequence of Caesarean, hysterectomy, gynecological surgery, urologic surgery and some traditional practices.</span></span> </p>展开更多
Introduction Female genital fistula remains a global concern especially in incoming countries. The majority of cases resulted from obstructed delivery labor. The treatment is by surgery exceptional by probe for very s...Introduction Female genital fistula remains a global concern especially in incoming countries. The majority of cases resulted from obstructed delivery labor. The treatment is by surgery exceptional by probe for very small cases. But some ones remain incurable after several surgery theaters. The objective of this study is to establish the epidemiology anatomopathological types and prognosis of FGF considered being incurable in our center. Methods This is a retrospective and prospective descriptive study from January 2, 2017 to July 14, 2021 on incurable cases of female genital fistula recorded at the Centre National de Réparation de Fistule Obstétricale (CNRFO) of Niamey for complex cases of fgf. The epidemiology, the lesions of vagina, uretra, bladder, the treatment and prognosis have been studied. Results A total of 522 cases were operated within 5 cases given incurable (0.95%). The 5 cases were 37 - 49 years old, they had fistula at their first delivery, the mean age of the fistula was around 9 years. The anatomopathological founds were vaginal severe sclerosis, extensive supra-trigonal fistula, total ureteral destruction, and partial bladder destruction. All the 5 patients treated by surgery were declared incurable. Conclusion Female genital fistula is not life-threatening but a major definitive handicap for theses prim parous. The treatment fail is linked with local lesions, continuous urine and fecal incontinency, added by iterative surgery. They remain judged incurable whether a surgery was by skilled practitioner.展开更多
Introduction: Obstetric fistula is a public health problem but its prevalence remains unknown in Niger. We report epidemiological and anatomopathological status of new cases of female genital fistula. Method: Multicen...Introduction: Obstetric fistula is a public health problem but its prevalence remains unknown in Niger. We report epidemiological and anatomopathological status of new cases of female genital fistula. Method: Multicentre prospective study over 15 months (January 1st, 2016 to March 31st, 2017) in 5 national centers for the therapeutic management of female genital fistula. Data were collected from focus groups, observations and pre-established individual survey form and hospital records. Results: During the 15-month survey period, 148 new cases of female genital fistula of obstetric origin were recorded. Patients aged 15 to 19 accounted for 40% of cases. They were married before the age of 16 (55.4%), out of school in 89.2% and 77.2% lived outside the matrimonial home. The patients came from rural areas (96%) of the cases, the labor of delivery lasted more than 24 hours in 71.6% and in 95.3% of the cases the delivery was initiated at home and then finished in a health facility, 33.8% had assisted vaginal delivery (forceps/suction cup), 23% by caesarean section and 10.81% by laparotomy for uterine rupture. Fistula occurred during first delivery (47.3%) and recurrence accounted for 5.4% of cases. Perinatal death accounted for 85.1%. Conclusion: Female genital fistula of obstetric origin remains a major public health problem in Niger despite the efforts made.展开更多
文摘<p> <b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:""><span style="font-family:Verdana;">Female genital fistula (FGF), remains a world concern, especially in low developed country. Obstructive (blocked) delivery labor is his principal cause, sometimes by pelvic surgery (urogenital or obstetrical, rectal) more rarely by congenital urogenital malformation, excision, pelvic neoplasm, pelvic radiotherapy. We were interested in iatrogenic FGF treated in the special referral fistula center. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">We report 35 cases of iatrogenic female genital fistula. Are included only cases by urogenital surgery, excision in the National Referal Center of Obstetrical Fistula. Were not included cases happened by over 12 hours blocked delivery labor, caustic destruction, pelvic cancer pelvic infection and those with incomplete file. The epidemiologic, clinical and therapeutic information were studied. All ethical protocols were respected. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">CNRFO recorded 743 cases of female genital fistula from May 23 2013 to May 23 May 2018 within 35 iatrogenic cases (4.71%). Patients were 19 - 29 years old (42.85%), average age 35 years old, extremes 19 - 60 years, without occupation (82.86), grand multiparous 48.57%, with a mean of 4 previous deliveries. The principal constancies were hysterectomies 71.43%, caesarean section 17.14%, genital excision 11.42%, and cystocele cure 11.42%. The anatomical finds were soft vagina tissue 97.14% uretero-vaginal fistula 45.71% (2 cases post Caesarean, 14 cases post hysterectomy), vesico-vaginal 31.43% (all post hysterectomy), ureteral 11.42% (all post caesarean), 1 vesico-uterine 5.71% (case post caesarean), 1 case after a cystocele cure, 2 uretro-vaginal 11.42% secondary of genital excision. Treatment was ureteral reimplantation (18/31) cases by abdominal way, fistulorraphy (12/31) and 1uretroplasty by vaginal, 4 cases treated with transurethral bladder probe. 30 were cured by fistulas surgery, 1 urinary tress incontinency and 1 not closed, and 4 of transurethral bladder probe were cured. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The female genital fistula is sometimes the consequence of Caesarean, hysterectomy, gynecological surgery, urologic surgery and some traditional practices.</span></span> </p>
文摘Introduction Female genital fistula remains a global concern especially in incoming countries. The majority of cases resulted from obstructed delivery labor. The treatment is by surgery exceptional by probe for very small cases. But some ones remain incurable after several surgery theaters. The objective of this study is to establish the epidemiology anatomopathological types and prognosis of FGF considered being incurable in our center. Methods This is a retrospective and prospective descriptive study from January 2, 2017 to July 14, 2021 on incurable cases of female genital fistula recorded at the Centre National de Réparation de Fistule Obstétricale (CNRFO) of Niamey for complex cases of fgf. The epidemiology, the lesions of vagina, uretra, bladder, the treatment and prognosis have been studied. Results A total of 522 cases were operated within 5 cases given incurable (0.95%). The 5 cases were 37 - 49 years old, they had fistula at their first delivery, the mean age of the fistula was around 9 years. The anatomopathological founds were vaginal severe sclerosis, extensive supra-trigonal fistula, total ureteral destruction, and partial bladder destruction. All the 5 patients treated by surgery were declared incurable. Conclusion Female genital fistula is not life-threatening but a major definitive handicap for theses prim parous. The treatment fail is linked with local lesions, continuous urine and fecal incontinency, added by iterative surgery. They remain judged incurable whether a surgery was by skilled practitioner.
文摘Introduction: Obstetric fistula is a public health problem but its prevalence remains unknown in Niger. We report epidemiological and anatomopathological status of new cases of female genital fistula. Method: Multicentre prospective study over 15 months (January 1st, 2016 to March 31st, 2017) in 5 national centers for the therapeutic management of female genital fistula. Data were collected from focus groups, observations and pre-established individual survey form and hospital records. Results: During the 15-month survey period, 148 new cases of female genital fistula of obstetric origin were recorded. Patients aged 15 to 19 accounted for 40% of cases. They were married before the age of 16 (55.4%), out of school in 89.2% and 77.2% lived outside the matrimonial home. The patients came from rural areas (96%) of the cases, the labor of delivery lasted more than 24 hours in 71.6% and in 95.3% of the cases the delivery was initiated at home and then finished in a health facility, 33.8% had assisted vaginal delivery (forceps/suction cup), 23% by caesarean section and 10.81% by laparotomy for uterine rupture. Fistula occurred during first delivery (47.3%) and recurrence accounted for 5.4% of cases. Perinatal death accounted for 85.1%. Conclusion: Female genital fistula of obstetric origin remains a major public health problem in Niger despite the efforts made.
