ABSTRACT
Defi ned as circumferential eversion of the epithelium of the distal urethra, mucosal prolapse of the urethra occurs in the girl child. The diagnosis is clinical but may be overlooked or confused with other conditions. Treatment remains controversial. The aim was to describe the anatomical and therapeutic aspects. Methods. This was a retrospective and descriptive study over 5 years. Age, time of admission and circumstances of occurrence were analysed. Clinical aspects were based on the length of the prolapse (small less than 1 cm, medium: between 1 and 2 cm, large more than 2 cm), the colour of the prolapse and the presence or absence of bleeding. The treatment was medical (hormonal) and surgical in case of failure of hormonal treatment. The evaluation of the results was based on the occurrence of recurrence and urinary incontinence. The average follow-up was 18 months. Results. Twenty-one patients were included in the study with a mean age of 6.5 years. The mean time to onset was 12.4 days. Vulvar bleeding was the reason for consultation in n=9 patients. The prolapse was large in 12 patients, medium in 9 patients and small in 3 patients. The prolapse was violaceous in 15 patients. Medical
Subject(s)
Humans , Therapeutics , Uterine Prolapse , Intraepithelial Lymphocytes , Urethra , Clinical DiagnosisABSTRACT
Objectifs. Decrire les types de prolapsus genitaux et en analyser les complications post-chirurgicales au Centre Hospitalier Universitaire Souro Sanou (CHUSS) de Bobo-Dioulasso. Methode. Etude prospective et descriptive de 39 patientes operees de prolapsus genital entre le 1er avril 2005 et le 30 septembre 2006. Le follow-up a ete effectue 6 semaines; 3mois; puis 6 mois apres la chirurgie. Un questionnaire ecrit; semi-structure a permis le recueil de donnees cliniques et les protocoles operatoires ont ete revus. Resultats : Trente-neuf patientes; porteuses de 84 types de prolapsus diagnostiques (42;86); ont ete operees; representant pres de 10 de l'ensemble d'interventions gynecologiques programmees. La frequence annuelle des prolapsus genitaux en consultation gynecologique etait de 4;2. Les lesions etaient souvent associees (77) et interessaient les 3 etages dans 49 des cas. La cystocele etait la plus frequente (79;5); suivie de la rectocele (71;8) et des hysteroceles (50). Deux tiers des interventions concernaient les prolapsus de degre 4. Six techniques operatoires ont ete repertoriees; la plus frequente etant la triple operation perineale (51;3). Les complications per operatoires (15;4) ont ete : une plaie vesicale; deux plaies rectales; et trois cas d'hemorragies. Deux patientes ont developpe une retention urinaire aigue en postoperatoire immediat (5;1). A 6 mois de suivi postoperatoire; 7 cas de recidives (15;38) ont ete enregistres : parmi lesquels; 6 cystoceles apparues des la 6eme semaine. Conclusion : La cystocele est le type de prolapsus le plus frequent dans notre service ; elle en represente avec l'hemorragie; les principales complications postchirurgicales; justifiant l'elaboration de lignes directrices pour une prise en charge efficace de cette pathologie