| Popis: |
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 |
