Results of the Management of Urogenital Fistulae from Community Caravans

Objective: To report the experience of surgical caravans for urogenital fistulascare. Methodology: This was a retrospective study covering the period fromJanuary 2014 to December 2014 and which took place on 7 sites of fistula care.The epidemiological, anatomoclinical, therapeutic and evolutionary aspectswere studied. Results: 346 patients were operated during 14 caravans. Theiraverage age was 33.11 years (range: 12 to 70 years). Most of these patientswere without remunerative activities (80%) and without education (63.3%).The average duration of fistula progression was 6.08 years (range: 0 to 42years). Obstetrical etiology was predominant (87.9%). According to the classificationof 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 thetransvaginal route (82.1%). The vesicovaginal splitting with separated sutureof the bladder and the vagina was the basic technique (94.7%). The therapeuticresults were judged after a follow-up of 1 month and 3 months. Across thecohort, 80 patients (23.1%) were lost of sight for follow-up at 1 month and245 (70%) at 3 months. The success rates evaluated in patients reviewed at 1month and 3 months were respectively 70% and 64%. Conclusion: The incidenceof urogenital fistulas is still high in Cote du0027Ivoire. Various anatomoclinicalvarieties have been identified and treated with satisfactory results inpoorly equipped local structures.