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[ Article ] Urologic Complications after Gynaecologic and Obstetric Surgery at the Urology-Andrology Teaching Clinic of Teaching Hospital of Cotonou

Date de soumission: 03-05-2017
Année de Publication: 2014
Entité/Laboratoire Unité d'Urologie (UU)
Document type : Article
Discipline(s) : Urologie & Néphrologie
Titre Urologic Complications after Gynaecologic and Obstetric Surgery at the Urology-Andrology Teaching Clinic of Teaching Hospital of Cotonou
Auteurs HOUNNASSO PRINCE PASCAL [1], AVAKOUDJO JOSUÉ DEJINNIN GEORGES [2], BABADI Naméoua [3], PARE A. [4], OUATTARA A. [5], VODOUNOU A. [6], AGOUNKPE M. M. [7],
Journal: Open Journal of urology
Catégorie Journal: Internationale
Impact factor: 0
Volume Journal: 4
DOI: 10.4236/oju.2014.410021
Resume Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a retrospective study of patients referred with urologic complications following obstetric and gynaecological surgeries. The study took place at the Teaching Clinic of Urology Andrology at CNHU of Cotonou between April 1, 2008 and March 31, 2013. Results: Fortyone patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 year swith range of 20 and 57 years. Twenty-one (51.2%) of them were married. Thirty patients (73.2%) were referred from a non-academichospital, while 7 patients (17.1%) were referred from academic hospital. Caesarean section was the primary gynecological surgery in 22 cases (53.7%) and hysterectomy in 19 cases (46.3%). Clinically, the predominant symptoms were leakage of urine throughout the vagina and obstructive anuria with or without back pain. We found 31 cases of VVF, 5 cases of bilateral ligation of the ureters, 3 cases of unilateral ligation of the ureter, 1 ureteralinjury and 1 uretero-vaginal fistula. These complications were diagnosed postoperatively in 95.1% of cases. Surgeries done included VVF repair in 31 cases (75.6%), unilateral ureteral reimplantation in 4 cases (9.8%), removal of ligation of the ureters in 3 cases (7.3%), bilateral ureteral reimplantation for 2 cases (4.9%) and end-to-end anastomosisin 1 case (2.4%). The postoperative period was uneventful in 29 cases and we observed 7 cases of surgical site infection. The overall success rate was 87.8%. Conclusion: Urological complications following gynecologic surgeries managed at the urologic department of teaching hospital of Cotonou had an even higher incidence. Early diagnosis especially during the operative procedure would save the patients’ serious complications and open surgery due to the lack of endo-urological facilities. The most important factor in prevention is good knowledge of pelvicanatomy and good knowledge of the surgical techniques of caesarean operation section and trans-abdominal hysterectomy.
Mots clés Urological Complications, Gynaecological and Obstetrical Surgery, Cotonou
Pages 121 - 125
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