Results of the Management of Urogenital Fistulae from Community Caravans

Objective: To report the experience of surgical caravans for urogenital fistulas care.Methodology: This was a retrospective study covering the period from January 2014 to December 2014 and which took place on 7 sites of fistula care.The epidemiological, anatomoclinical, therapeutic and evolutionary aspects were studied.Results: 346 patients were operated during 14 caravans.Their average age was 33.11 years (range: 12 to 70 years).Most of these patients were without remunerative activities (80%) and without education (63.3%).The average duration of fistula progression was 6.08 years (range: 0 to 42 years).Obstetrical etiology was predominant (87.9%).According to the classification of Kees Waaldijk, fistulas were divided into type I (67.4%), type II (21.1%), and type III (11.5%).The most common surgical approach was the transvaginal route (82.1%).The vesicovaginal splitting with separated suture of the bladder and the vagina was the basic technique (94.7%).The therapeutic results were judged after a follow-up of 1 month and 3 months.Across the cohort, 80 patients (23.1%) were lost of sight for follow-up at 1 month and 245 (70%) at 3 months.The success rates evaluated in patients reviewed at 1 month and 3 months were respectively 70% and 64%.Conclusion: The incidence of urogenital fistulas is still high in Côte d'Ivoire.Various anatomoclinical varieties have been identified and treated with satisfactory results in poorly equipped local structures.