Introduction: Complete cervico-urethral transection is a vesicovaginal fistula characterized by total disinsertion of the urethra from the bladder. It is a fistula of the cervico-urethral intersection threatening the mechanism of continence. The aim of this study was to describe the epidemiological and therapeutic aspects of this type of fistula. Patients and Methods: This was a descriptive retrospective study on patients who have had surgery for cervico-urethral transection from June 01, 2012 to June 01, 2015. Results: Cervico-urethral transections (n = 76) accounted for 33.77% of all urogenital fistulas admitted to our department of surgery during the study period. The average age was 25.02 ± 8, 6 years. Married patients accounted for 85.58%, 72.36% had not received any classical education. Fistulas less than one year old made up 56.58% of cases, associated lesions were perineal tears 25.0%, vaginal sclerosis, 21.05%, vaginal straps, 13.15%, rectovaginal fistula, 2.63% and the shortness of the urethra less than 2.5 cm in 42.10% of cases. All surgeries were performed vaginally with a 98.68% fistula closure rate and an average of 1.68 surgeries per patient. After closure of the fistula, 10.67% of patients presented a residual urinary incontinence. Conclusion: Complete cervico-urethral transection is a frequent vesicovaginal fistula. She sometimes exposes to urinary incontinence after closing the fistula. The results of his surgery are often good at the cost of multiple intervention.
Bouffioux, C.H. and de Leval, J. (1987) Expérience comparée des fistules vésico-vaginale en Belgique et en Guinée Conakry. Acta Urologica Belgica, 55, 597-607.
Mahfouz, N. (1957) Urinary Fistulae in Women. BJOG, 64, 23-34. https://doi.org/10.1111/j.1471-0528.1957.tb02595.x
Arrowsmith, S., Hamlin, E.C. and Wall, L.L. (1996) Obstructed Labor Injury Complex: Obstetric Fistula Formation and the Multifaceted Morbidity of Maternal Birth Trauma in the Developing World. Obstetrical & Gynecological Survey, 51, 568-574. https://doi.org/10.1097/00006254-199609000-00024
Ndiaye, P., AmoulKini, G., Adama, F., Idrissa, A. and Tal-Dia, A. (2009) Urogenital Fistula of Obstetric Origin (Fugo): Cost of Care at the Niamey National Hospital (Niger). Revue d’épidémiologie et de Santé Publique, 57, 374-379. https://doi.org/10.1016/j.respe.2009.04.010
Aristide Kabore, F., Kambou, T., Ouattara, A., Zango, B., Yameogo, C., Kirakoya, B., et al. (2014) Epidemiological, Etiological and Psychosocial Aspects of Urogenital Fistula in a Cohort of 170.
WHO (2006) Obstetric Fistula: Guiding Principles for Clinical Management and Programme Development. World Health Organization, Geneva.
Camey, M. (1998) Les fistules obstétricales. Progès en Urologie, Paris, 328.
Benchekroun, A., Lakrissa, A., Essakali, H.N., Faik, M., Abbaka, T., Hachimi, M., Marzouk, M. and Benabderrazek, T. (1987) Vesicovaginal Fistulas: About 600 Cases. Journal of Urology (Paris), 93, 151-158.
Benchekroun, A., El Alj, H.A., El Sayegh, H., Lachkar, A., Nouini, Y., et al. (2003) Vesico-Vaginal Fistula: Report of 1050 Cases. Annales d’Urologie, 37, 194-198. https://doi.org/10.1016/S0003-4401(03)00053-6
Gueye, S.M., Ba, M., Sylla, C., Diagne, B.A. and Mensah, A. (1992) Vesico-Vaginal Fistulas: Etiopathogenic and Therapeutic Aspects in Senegal. Journal of Urology, 98, 148-151.
Creanga, A.A. and Genadry, R.R. (2007) Obstetric Fistulas: A Clinical Review. International Journal of Gynecology & Obstetrics, 99, S40-S46. https://doi.org/10.1016/j.ijgo.2007.06.021
Diakité, M.L., Ouattara, K. and Tembely, A. (2015) Some Thoughts on the Classification of African Obstetric Fistula. Médecine et Santé Tropicales, 25, 146-155. https://doi.org/10.1684/mst.2014.0387
Dumurgier, C. and Falandry, L. (2012) The Surgery of Obstetric Fistulas. Bulletin de L’Académie Nationale de Médecine, 196, 1535-1556.
Demisew, A.S., Ahadu, W.A. and Desta, H.G. (2016) Characteristics and Repair Outcome of Patients with Vesicovaginal Fistula Managed in Jimma University Teaching Hospital, Ethiopia. BMC Urology, 16, 41. https://doi.org/10.1186/s12894-016-0152-8
Musa, K., Ssalongo, W., Kabakyenga, J., Mukiibi, N., Senkungu, J., Stenson, A. and Mukasa, P. (2011) Predictors and Outcome of Surgical Repair of Obstetric Fistula at a Regional Referral Hospital, Mbarara, Western Uganda. BMC Urology, 11, 23. https://doi.org/10.1186/1471-2490-11-23
Diallo, A.B., Sy, T., Baha, M.D., Diallo, T.M.O., Barry, M.S., Baha, I., Barry, T.H., Blanchote, J., Rochat, C.H. and Diallo, M.B. (2016) Obstetric Vesicovaginal Fistulas in Guinée: Analysis of Data from Tree Care Site of the OGN Engender Health. Progrès en Urologie, 26, 145-151. https://doi.org/10.1016/j.purol.2016.01.006
Moudouni, S., Nouri, M., Koutani, A., Attya, A.I., Hachimi, M. and Lakrissa, A. (2001) Obstetric Vesicovaginal Fistulas. About 114 Cases. Progrès en Urologie, 11, 103-108.
Egziabher, T.G., Ngoga, E., Karenzi, B. and Kateera, F. (2015) Obstetric Fistula Management and Predictors of Successful Closure among Women Attending a Public Tertiary Hospital in Rwanda: A Retrospective Review of Records. BMC Research Notes, 8, 774. https://doi.org/10.1186/s13104-015-1771-y
Maheu-Giroux, M., et al. (2015) Prevalence of Symptoms of Vaginal Fistula in 19 Sub-Saharan Africa Countries: A Meta-Analysis of National Household Survey Data. The Lancet Global Health, 3, e271-e278. https://doi.org/10.1016/S2214-109X(14)70348-1
D’Elia, C., Curti, P., Cerruto, M.A., Monaco, C. and Artibani, W. (2015) Large Urethro-Vesico-Vaginal Fistula Due to a Vaginal Foreign Body in a 22-Year-Old Woman: Case Report and Literature Review. Urologia Internationalis, 95, 120-124. https://doi.org/10.1159/000365421
Ichihara, K., Masumori, N., Takahashi, S., Miyao, N. and Kato, R. (2015) Bladder Neck Rupture and Vesicovaginal Fistula Associated with Pelvic Fracture in Female. Lower Urinary Tract Symptoms, 7, 115-117. https://doi.org/10.1111/luts.12056
Goh, T.W.J., Browning, A. and Chang, A. (2008) Predicting the Risk of Failure of Closure of Obstetric Fistula and Residual Urinary Incontinence Using a Classification System. International Urogynecology Journal, 19, 1659-1662. https://doi.org/10.1007/s00192-008-0693-9
Ministère de la Santé du Mali (2009) Stratégie Nationale de Prévention et de prise en charge de la fistule obstétricale. “Zéro cas de fistule obstétricale”. Bamako, Janvier 2009, 30 p.
Browning, A. (2004) Prevention of Residual Urinary Incontinence Following Successful Repair of Obstetric Vesicovaginal Fistula Using Fibro Muscular Sling. BJOG, 111, 357-361. https://doi.org/10.1111/j.1471-0528.2004.00080.x
Arrowsmith, S.D. (1994) Genitourinary Reconstruction in Obstetric Fistulas. Journal of Urology, 152, 403-406. https://doi.org/10.1016/S0022-5347(17)32749-0
Tebeu, P.M., Fokom-Domgue, J., KengneFosso, G., TjekBiyaga, P., Nelson Fomulu, J. and Rochat, C.H. (2015) Comparative Study of the Result of the Cure of Vesicovaginal Fistulas with and without Interposition of the Flap of Martius: A Cameroonian Experience. Progrès en Urologie, 25, 1225-1231. https://doi.org/10.1016/j.purol.2015.07.005