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


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: Forty-one patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 years 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 pre- dominant 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 Coto-nou 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.

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Pascal, H. , Georges, A. , Naméoua, B. , Karim, P. , Adama, O. , Alexandre, V. and Michael, A. (2014) Urologic Complications after Gynaecologic and Obstetric Surgery at the Urology-Andrology Teaching Clinic of Teaching Hospital of Cotonou. Open Journal of Urology, 4, 121-125. doi: 10.4236/oju.2014.410021.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Bouya, P.A., Odzébé, A.W.S., Otiobanda, F.G., et al. (2011) Les Complications urologiques de la chirurgie gynécologique. Progrès en Urologie, 21, 875-878.
[2] Zoung-Kanyi, J. and Sow, M. (1990) Le Point sur les fistules vésico-vaginales à l’hopital central de Yaoundé: A propos de 111 cas observés en Dix ans. Urology Annals, 24, 457-641.
[3] Minar, L., Weinberger, V. and Kysela, P. (2010) Complications of Radical Onco-Gynecological Operations. Ceska Gynekologie, 75, 346-352.
[4] Symmonds, R.E. (1976) Ureteral Injuries Associated with Gynecologic Surgery: Prevention and Management. Clinical Obstetrics & Gynecology, 19, 623-644. http://dx.doi.org/10.1097/00003081-197609000-00012
[5] Carley, M.E., McIntire, D., Carley, J.M. and Schaffer, J. (2002) Incidence, Risk Factors and Morbidity of Unintended Bladder or Ureter Injury during Hysterectomy. International Urogynecology Journal, 13, 18-21. http://dx.doi.org/10.1007/s001920200004
[6] Culty, T., Leret, T. and Botto, H. (2008) Lesions opératoires de l’urétère. EMC-18-160-A-10.
[7] Diallo, M.B., Diallo, A.T., Sow, K.B., et al. (2001) Les Complications urologiques de la chirurgie gynécologique. A propos de 16 cas. Annales d’Urologie, 35, 210-215.
[8] Tazi, M.F., Athalial, Y., Ahsaini, M., et al. (2010) Plaies vésicales d’origine gynéco-obstétricale à propos de 20 cas. Journal Marocain d’Urologie, 17, 17-21.
[9] Bentaleb, H., Bensouda, A., Kabbaj, M., Karimouni, T., Tazi, K., et al. (2007) Prise en charge des traumatismes iatrogène de l’uretère: A propos de 24 cas. African Journal of Urology, 13, 219-225.
[10] Rajasekar, D. and Hall, M. (1997) Urinary Tract Injuries during Obstetric Intervention. BJOG: An International Journal of Obstetrics & Gynaecology, 104, 731-734. http://dx.doi.org/10.1111/j.1471-0528.1997.tb11986.x
[11] Blandy, J.P., Badenoch, D.F., Fowler, C.G., et al. (1991) Early Repair of Iatrogenic Injury to the Ureter or Bladder after Gynecological Surgery. Journal of Urology, 146, 761-765.
[12] Mattingly, R.F. and Thompson, J.D. (1985) Telinde’s Operative Gynecology. 6th Edition, J.B. Lippincott & Co., Philadelphia.
[13] Kamouni, T., Patard, J.J., Bensalah, K., et al. (2001) Prise en Charge urologique des traumatismes iatrogènes de l’uretère. Progrès en Urologie, 11, 642-646.

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