RESUMO
OBJECTIVES: The aim of the study was to determine the etiologic and epidemiological aspects of the obstetrical uro-genital fistulas in Congo in order to propose a strategy of prevention. PATIENTS AND METHODS: It is a retrospective study concerning 34 files of obstetrical uro-genital fistulas selected within 7 years in the department of Urology of the University Hospital Center of Brazzaville. The etiopathogenic, anatomoclinical and therapeutic aspects have been analysed for each file. RESULTS: The uro-genital fistula represents 23% of the female admissions in urology and 85% of them are related to obstetrical causes. Fifty-five percent of the patients were less than 30 years old, most of them being primiparas. Sixty-one percent of the patients came from rural areas. The prolonged time of the delivering labour and the foetal extraction manoeuvres were the main mechanisms causing the fistulas. With the surgical therapy, 77% of the abnormalities have been treated. CONCLUSION: In spite of progress made in the realm of surgical techniques, the best treatment for uro-genital fistulas remains their prevention as targeted on the education for health and the management of pregnant women. Besides, the development of the infrastructure of health and roads, the training and reeducation of the health personnel contribute to improve this management.
