Author(s)

Timongo Françoise Danielle Millogo/Traore^1*, Kiswendsida Bonkoungou¹, Fasnéwindé Aristide Kabore², Ali Ouedraogo¹, Léonie Claudine Lougue/Sorgho³

¹Department of Obstetrics and Gynaecology, Yalgado Ouédraogo University Hospital, Ouagadougou, Burkina Faso.
²Department of Urology and Andrology, Yalgado Ouédraogo University Hospital, Ouagadougou, Burkina Faso.
³Department of Radiology and Imaging, Charles de Gaulle University Hospital, Ouagadougou, Burkina Faso.

Objective: To describe the aetiology, clinical presentation, management and outcomes of a series of patients with iatrogenic lesions of the ureter following obstetric or gynaecological surgery treated at Yalgado Ouedraogo University Hospital, Ouagadougou, Burkina Faso. Methods: This is a case series looking at 14 consecutive patients from 1 January 2011 to 28 February 2017, operated on for urological complications following obstetric and gynaecological surgery. Results: Our study focused on fourteen cases. The average age was 32.9 years (range 20 - 60 years). Thirteen were housewives. Eleven lived in rural areas. The aetiological factor was Caesarian section in seven cases, laparotomy in four cases and hysterectomy in three cases. The type of ureteral injury was bilateral ligation in nine cases. The average time to diagnosis was 16 days (range 2 - 120 days). Anuria was the commonest presenting symptom. Ultrasound in ten patients showed evidence of uretero-hydronephrosis. Eight patients required renal dialysis. Surgical management was uretero-vesical re-implantation in eleven cases, disunion of sutures associated with catheterization in two cases and a termino-terminal ureteral anastomosis in one case. The average hospital stay was 26 days (range 9 - 44 days). The post-operative period was complicated by two cases of vesico-vaginal fistula, one case of parietal suppuration, one case of pyelonephritis and one case of hydronephrosis. No deaths were recorded and a complete cure was ultimately obtained in all patients. Conclusion: Urological complications of obstetric and gynaecological surgery are dominated by ligation of the ureters in our setting. Caesarian section is the commonest cause. Treatment is essentially surgical.

Iatrogenic Lesion, Ureter, Obstetric and Gynaecological Surgery

Millogo/Traore, T. , Bonkoungou, K. , Kabore, F. , Ouedraogo, A. and Lougue/Sorgho, L. (2018) Iatrogenic Lesions of the Ureter Following Obstetric or Gynaecological Surgery Managed at Yalgado Ouedraogo University Hospital: A Series of 14 Cases. Open Journal of Obstetrics and Gynecology, 8, 106-112. doi: 10.4236/ojog.2018.82014.