Contribution of Laparoscopy in the Management of Female Infertility in Low Resource Countries: A Review of 208 Cases at the Yaoundé General Hospital, Cameroon

Autor:	Jean Marie Kasia, Anny Ngassam, Alexis Medou, Jovanny Fouogue Tsuala, Jean Dupont Kemfang Ngowa, Victorine Nkongo, Philemon Nsem
Rok vydání:	2015
Předmět:	Infertility medicine.medical_specialty Tuboplasty medicine.diagnostic_test Obstetrics business.industry medicine.medical_treatment Female infertility medicine.disease Salpingectomy Laparotomy medicine business Laparoscopy Pelvic Infection Hydrosalpinx
Zdroj:	International Journal of Clinical Medicine. :934-939
ISSN:	2158-2882 2158-284X
DOI:	10.4236/ijcm.2015.612122
Popis:	Background: Infertility is a global problem, but the highest prevalence is in low resource countries, particularly in sub-Saharan Africa where tubal damage following pelvic infection is the commonest cause. Objectives: This study aimed to assess contribution of laparoscopy as a diagnostic and therapeutic tool in infertile women in our setting. Methods: A descriptive review of complete medical records of 208 women who underwent laparoscopy at the Gynaecology Unit of Yaounde General Hospital from December 2007 to December 2012. Results: Two hundred and eight women were enrolled in this study. Mean age was 32.6 ± 11.25 years. Infertility was secondary in 71.6% of cases; 125 (60.1%) women were married and 116 (55.8%) had a positive serology of Chlamydia trachomatis infection. The most frequent findings during diagnostic laparoscopy were: pelvic adhesions (83.7%), hydrosalpinx (21.6%), pyosalpinx (4.8%), perihepatic adhesions (25.5%), uterine fibromas (22.6%), pelvic endometriosis (13%) and ovarian abnormalities (10.1%). The surgical procedures during laparoscopy were: adhesiolysis (79.7%), tuboplasty (35.0%), salpingectomy (8.2%), ovarian cystectomy (5.8%) and myomectomy (1.9%). Three (1.4%) cases of uterine perforation and 1 (0.5%) case of laparoscopy conversion to laparotomy were observed. Conclusion: Diagnostic laparoscopy revealed that tubal lesions and pelvic adhesions were still the major causes of female infertility in developing countries. Adhesiolysis and tuboplasty were the most frequently performed surgical procedures during laparoscopy. Therefore, training in endoscopic surgery should be regarded as an important issue in developing countries.
Databáze:	OpenAIRE
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