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Introduction <p>This study aimed to characterize the typology, analyze the etiological factors, and evaluate the outcomes of surgical management of iatrogenic urogenital fistulas (IUGF).</p> Methods <p>A bicentric descriptive and analytical study with retrospective data collection, including cases of IUGF operated between January 2020 and December 2023 at the Regional Hospital of Labé and the Ignace Deen University Hospital (Guinea). Univariate statistical analyses (Fisher’s exact test) and stratified multivariate analyses were performed to identify significant associations between variables. The dependent variables studied were the type of fistula and the timing of management, while the independent variables included age, etiological factors, symptomatology, and residence.</p> Results <p>IUGF represented 12.42% of urogenital fistulas. The mean age was 32.2 years with a rural predominance (91.07%). Statistical analyses identified two distinct epidemiological and clinical profiles: post-cesarean vesicouterine fistulas on one hand and post-hysterectomy fistulas on the other.The main etiological factors were cesarean Sect.&#xa0;(78.57%) and hysterectomy for uterine rupture (17.86%). According to the type of IUGF, vesicouterine fistulas were most frequently observed (80.36%), followed by vesicovaginal fistulas (10.72%) and ureterovaginal fistulas (8.93%). The main clinical presentation corresponded to Youssef’s syndrome (75%). Finally, regarding surgical management, the transvesical extraperitoneal approach was the preferred method (85.71%), with a closure rate of 100%.</p> Conclusion <p>Iatrogenic urogenital fistulas occupy an increasing share in the epidemiology of fistulas in Guinea, with a clear predominance of post-cesarean vesicouterine fistulas. Post-cesarean vesicouterine fistulas and post-hysterectomy vesicovaginal and uterovaginal fistulas are the two distinct clinical profiles identified, requiring targeted diagnostic, therapeutic, and preventive approaches.</p>

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Iatrogenic urogenital fistulas in Guinea: study of etiological factors and analysis of surgical management

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Mamadou Diawo Bah,
  • Alexandre vahina Gamamou,
  • Lahoumbo Ricardo Gnammi,
  • Aboubacar Cherif,
  • Hady Kaba,
  • Fatoumata Binta Baldé,
  • Daouda Kanté,
  • Kindy Diallo,
  • Thierno Mamadou Oury Diallo,
  • Abdoulaye Bobo Diallo,
  • Oumar Raphiou Bah

摘要

Introduction

This study aimed to characterize the typology, analyze the etiological factors, and evaluate the outcomes of surgical management of iatrogenic urogenital fistulas (IUGF).

Methods

A bicentric descriptive and analytical study with retrospective data collection, including cases of IUGF operated between January 2020 and December 2023 at the Regional Hospital of Labé and the Ignace Deen University Hospital (Guinea). Univariate statistical analyses (Fisher’s exact test) and stratified multivariate analyses were performed to identify significant associations between variables. The dependent variables studied were the type of fistula and the timing of management, while the independent variables included age, etiological factors, symptomatology, and residence.

Results

IUGF represented 12.42% of urogenital fistulas. The mean age was 32.2 years with a rural predominance (91.07%). Statistical analyses identified two distinct epidemiological and clinical profiles: post-cesarean vesicouterine fistulas on one hand and post-hysterectomy fistulas on the other.The main etiological factors were cesarean Sect. (78.57%) and hysterectomy for uterine rupture (17.86%). According to the type of IUGF, vesicouterine fistulas were most frequently observed (80.36%), followed by vesicovaginal fistulas (10.72%) and ureterovaginal fistulas (8.93%). The main clinical presentation corresponded to Youssef’s syndrome (75%). Finally, regarding surgical management, the transvesical extraperitoneal approach was the preferred method (85.71%), with a closure rate of 100%.

Conclusion

Iatrogenic urogenital fistulas occupy an increasing share in the epidemiology of fistulas in Guinea, with a clear predominance of post-cesarean vesicouterine fistulas. Post-cesarean vesicouterine fistulas and post-hysterectomy vesicovaginal and uterovaginal fistulas are the two distinct clinical profiles identified, requiring targeted diagnostic, therapeutic, and preventive approaches.