Matthieu Nkumu Loposso1, Jean Ndundu2, Gunter De Win3, Dieter Ost4, Augustin Maole Punga1, Dirk De Ridder5. 1. Department of Surgery, Urology Division, Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo. 2. Department of Obstetrics & Gynaecology, Saint Luc Hospital, Kisantu, Democratic Republic of Congo. 3. Department of Urology, University Hospital Antwerp, Antwerp, Belgium. 4. Department of Urology, St. Blasius Hospital, Dendermonde, Belgium. 5. Department of Urology, University Hospitals KU Leuven, Leuven, Belgium.
Abstract
OBJECTIVE: To study the profile of classification, etiology, and the relation between initial classification, and the results of vesicovaginal fistula surgery in a district hospital in DR Congo. METHODS: This study was based on the analysis of all consecutive patients being treated for VVF in Kisantu between November 2006 and November 2012. The fistula was classified according to the classification of Waaldijk. The location of VVF and degree of fibrosis were noted. Post-operatively, the first examination of patients took place a few days after catheter removal and subsequent review 2-3 months later. Statistical analysis was done in Graphpad Prism 6. RESULTS: Among 146 patients with VVF, 117 had a primary fistula. The majority of fistula was type I (56%) followed by type III (21%). The majority underwent a caesarean section (63.4%). The mean duration of labor was 30.7 hr. Delay in getting a caesarean in time was due to difficulties in reaching the hospital in 55%. Overall, the closure rate after the first surgical treatment was 65%. The continence rate of the patients with a successful closure was 63%. CONCLUSION: VVF can occur after caesarean section because of the prolonged labor that already causes ischemia and necrosis of the bladder wall and vesicovaginal septum before or while the caesarean section is being performed. Access to general hospitals and the management of the pregnant women needs to be improved. Despite a reasonable closure rate of 65%, post-fistula incontinence remains an important clinical problem.
OBJECTIVE: To study the profile of classification, etiology, and the relation between initial classification, and the results of vesicovaginal fistula surgery in a district hospital in DR Congo. METHODS: This study was based on the analysis of all consecutive patients being treated for VVF in Kisantu between November 2006 and November 2012. The fistula was classified according to the classification of Waaldijk. The location of VVF and degree of fibrosis were noted. Post-operatively, the first examination of patients took place a few days after catheter removal and subsequent review 2-3 months later. Statistical analysis was done in Graphpad Prism 6. RESULTS: Among 146 patients with VVF, 117 had a primary fistula. The majority of fistula was type I (56%) followed by type III (21%). The majority underwent a caesarean section (63.4%). The mean duration of labor was 30.7 hr. Delay in getting a caesarean in time was due to difficulties in reaching the hospital in 55%. Overall, the closure rate after the first surgical treatment was 65%. The continence rate of the patients with a successful closure was 63%. CONCLUSION: VVF can occur after caesarean section because of the prolonged labor that already causes ischemia and necrosis of the bladder wall and vesicovaginal septum before or while the caesarean section is being performed. Access to general hospitals and the management of the pregnant women needs to be improved. Despite a reasonable closure rate of 65%, post-fistula incontinence remains an important clinical problem.
Authors: A M Sih; D M Kopp; J H Tang; N E Rosenberg; E Chipungu; M Harfouche; M Moyo; M Mwale; J P Wilkinson Journal: BJOG Date: 2016-02-08 Impact factor: 6.531
Authors: Michel Mpunga Mafu; Don Félicien Kyongolwa Banze; Brian Tena Tena Aussak; Delphin Kolié; Bienvenu Salim Camara; Dolores Nembunzu; Christine Notia Amisi; Justin Lussy Paluku; Vandana Tripathi; Alexandre Delamou Journal: Trop Med Int Health Date: 2022-07-06 Impact factor: 3.918