Clinical Presentation, Therapeutic Aspects and Results of Urogental Prolapse in Yaounde

Abstract

Introduction: Urogenital prolapse is the descent of one or more elements of the abdominal-pelvic contents into the vaginal cavity. The anterior, middle and posterior anatomical compartments may be involved giving rise to several types of genital prolapse. However, there are various therapeutic modalities ranging from observational procedures to surgery. In Yaounde, urogenital prolapse appears to be a rare clinical entity, and its treatment has not been clearly stated. There is limited data about this subject in our context. Our aim was to study the clinical and therapeutic aspects of urogenital prolapse in Yaounde. Methods: We conducted a descriptive cross-sectional study with retrospective data collection at the Yaounde Gynaecological Obstetric and Pediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH) over a period of 05 months (from February 2022 to June 2022). All women aged ≥30 years and all women with documented urogenital prolapse admitted to the maternity and urology departments of these two health facilities were included. Data were collected using a structured questionnaire. Data was analyzed using IBM SPSS (statistical package for social sciences) software version 23.0 and the data were reported as mean, standard deviation, frequencies and percentages. Results: A total of 50 patients were recruited; the mean age was 45.8 ± 17 years. The age range was from 21 to 72 years. Majority of the patients were aged more than 55 years (32%). Most of the patients attended primary education (48%). Forty percent of the patients were housewives. The majority of the patients were from West Cameroon (26%). The most common reason for consultation was pelvic heaviness (54%). The most prevalent clinical sign was cystocele (56%), followed by hysterocele (54%). According to the Baden Walker classification, one-third of the patients were classified as first degree (36%). More than half (58%) of patients had the condition located at the first stage. Surgery was performed in 68% of cases while 48% received medical treatment. The average length of inpatient stay was 7.9 ± 3.7 days and the average length of transurethral catheterization was 3.02 ± 2.9 days. Most patients had a good short-term outcome, and the main postoperative complications were infection (8.8%) and hemorrhage (5.9%). Conclusion: Urogenital prolapse is a rare condition in our population. Diagnosis is essentially clinical. Cystocele and hysterocele are the predominant clinical forms. Surgery is the mainstay of treatment. Outcomes are satisfactory.