TITLE:
Urological Complications of Gynecological and Obstetric Interventions: Management at the Ignace Deen National Hospital—University Hospital of Conakry (Guinea)
AUTHORS:
Aissatou Taran Diallo, Yaya Diallo, Bah Oumar Raphiou, Koudazankpa Esaïe Mahugbé, Namory Keita, Naby Daouda Camara
KEYWORDS:
Urological Surgical Complications, Hysterectomy, Cesarean Section, Ureteral Injuries, Iatrogenic Urogenital Fistula, Surgical Reoperation
JOURNAL NAME:
Surgical Science,
Vol.8 No.12,
December
29,
2017
ABSTRACT: Introduction: pelvic abdominal surgery may be associated with urological complications requiring reoperation. The aim of this study was to evaluate the urological surgical complications of gynecological and obstetric procedures conducted at the Ignace Deen University Hospital of Conakry in Guinea. Methodology: This was a retrospective, cross-sectional, descriptive study of ten years, from 1 January 2006 to 21 December 2015. Results: Of 14,500 patients hospitalized in the maternity ward during the study period, 31 patients had secondary urological complications during gynecological or obstetric intervention 0.2%). The mean age of the patients was 34.77 years (range: 17 to 58 years). The mean duration of hospital stay was 13.29 days (range: 3 to 28 days). Signs of complication were mainly postoperative abdominal pain (64%, n = 20), vaginal urine leakage (19.35%, n = 6) and vaginal bleeding (9.68% n = 3). The diagnosis was mainly confirmed by ultrasound (70.45%, n = 31). The lesions were primarily ureteric (77.42%, n = 17) or on the urethral wounds (8.12%, n = 12). Urological complications mostly occurred during hysterectomy (41.94%, n = 13) and caesarean section (32.26%, n = 10). Repair procedures included uretero-vesical reimplantation (58.06%, n = 18), vesico-vaginal fistuloraphy (22.58%, n = 7), vesico-uterine fistuloraphy (12.90%, n = 4) and temporary ureterostomy (6.45%, n = 2). Treatment were successful in 28 patients (90.32%) and a lethality of 9.68% (n = 3) was recorded. Conclusion: Urological surgical complications of obstetric gynecological surgeries were mostly related to hysterectomy and Caesarean section performed by low-skilled surgeons, from peripheral facilities. Prevention measures should include better training and follow-up of practitioners from peripheral health facilities.