La fistule urétérovaginale après césariennes : diagnostic et traitement dans un hôpital à ressources limitées au Togo
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- 作者：T. M. Kpatcha ; K. Tengue ; A. Adodo…
- 关键词：Mots clésFistule urétérovaginale ; Dilatation urétérale ; Échographie rénale ; Réimplantation urétérovésicale ; Hôpital ; Togo ; Afrique intertropicale
- 刊名：Bulletin de la Société de pathologie exotique
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：109
- 期：5
- 页码：329-333
- 全文大小：
- 刊物主题：Internal Medicine; Tropical Medicine; Infectious Diseases; Gastroenterology; Epidemiology; Parasitology;
- 出版者：Lavoisier
- ISSN：1961-9049
- 卷排序：109
文摘
The purpose of this study is to describe a simple, non-expensive, accessible and effective technique of ureterovaginal fistula diagnosis, and to assess the results of surgical management in a resource-constrained hospital. During a campaign of obstetric fistulas repair, we diagnosed ureterovaginal fistulas by vaginal exam with the blue methylene test associated to abdominal ultrasonography, two simple and non-expensive explorations which permitted to identify ureterovaginal fistula and to do differential diagnosis with vesicovaginal fistula. The management was surgery, by ureterovesical reimplantation. Four ureterovaginal fistulas have been diagnosed in 32 women presented with obstetrical fistula. The mean age of those fistulas was 4.85 years; it was located on the left ureter in three cases, on the right in one case. The ureteral lesion was consecutive to a caesarean section in all patients and sited on the pelvic segment of ureter. In three patients, diagnosis was performed by the negativity of the blue test and unilateral dilation of ureter and kidney while the discovery was done during the treatment of vesicovaginal and rectovaginal fistulas associated in the last patient. After effects of surgery were simple, characterized by disappearance of urine leakage and dilation of ureter kidney. In resources-constrained context, techniques such as blue test and ultrasonography are enough to perform diagnosis of ureterovaginal fistula. Ureterovesical reimplantation is an effective therapeutic method for diagnosing ureterovaginal fistula.