[Psycho-social and economic reintegration of women operated for urogenital fistula]. / Réinsertion psycho-sociale et économique des femmes opérées pour fistules obstétricales et non obstétricales au Congo.

OBJECTIVE: To study the psycho-social and economic reintegration of women operated for genital fistula in Congo. MATERIAL AND METHODS: This was a descriptive observational study conducted in Brazzaville and Ewo, Republic of Congo, from April 1 to October 31, 2018. It included patients operated for genital fistula between 2008 and 2017. Variables of interest were socio-demographic, reproductive and clinical characteristics. The analysis was performed using the SPSS 20 software. RESULTS: The overall, 34 patients were studied, with age ranging from 29 to 65 years old with a median of 43 (39, 50) year. The context of fistula occurrence was obstetrical in 24 women (70%). The Practice of an income-generating activity before, during and after fistula was 76%; 32% and 64% (P=0.0007). Concerning the psychological status, in these women, self-esteem went from 26% to 73% (P=0.0003) and the prevalence of suicidal thoughts went from 29% before fistula treatment to 0% after (P=0.0009). The tendency to isolate themselves went from 44% before fistula cure to 3% after (P=0.00008). With regards to reproductive life, 54% of women had no desire for maternity and 17% did not have a desire of sexual intercourse. Only 26% of women benefited from the psychologist. Support. CONCLUSION: In this series, we observed a resumption of income-generating activities in women operated for a treatment of urogenital fistula and a psychological recovery with an increase in self-esteem and a decrease in suicidal thoughts. LEVEL OF EVIDENCE: 4.

[Obstetrical vesico-vaginal fistula in Guinea: Data analysis of three sites of treatment at Engender Health ONG]. / Fistules vésico-vaginales obstétricales en Guinée : analyse des données de 3 sites de prise en charge de l'ONG Engender Health.

OBJECTIVE: To analyze the management of obstetric vesico-vaginal fistula in the three sites of Engender Health in Guinea. PATIENTS AND METHODS: It was a retrospective study of descriptive type having helped collect 450 cases of vesico-vaginal fistulas in three support sites engender health between January 2008 and December 2011. The variables studied were epidemiological, clinical and therapeutic reasons and treatment outcomes were evaluated after a decline of at least six months. RESULTS: The mean age of onset of the fistula was 25years, ranging from 12 to 55years and 58.8% (n=265) of patients were aged between 18 and 30years. The mean duration of fistula was 11years, ranging from 1 to 38years. Eighty-two percent (n=416) of patients were housewives and 66.4% (n=299) off school. The complex fistula with 66% (n=297) was the most frequent. The treatment consisted of a fistulorraphie after splitting vesico-vaginal in 93.3% (n=420) of cases. Therapeutic results considered after a mean of 8months have resulted in a cure in 79.3% (n=357) of cases, improvement in 4.2% (n=19) of cases and failure in 16 4% (n=74) of cases. CONCLUSION: Vesico-vaginal fistula is a major cause of maternal morbidity in Guinea. The establishment of a real health policy based on sound medical and social structures contributes to its eradication. LEVEL OF EVIDENCE: 5.

[Comparative study of the outcome of surgical management of vesico-vaginal fistulas with and without interposition of the Martius graft: A Cameroonian experience]. / Étude comparative du résultat de la cure des fistules vésico-vaginales avec et sans interposition du lambeau de Martius: une expérience camerounaise.

INTRODUCTION: This study aimed to investigate whether Martius' graft has an effect on the outcome of the surgical management of genitourinary fistula. PATIENTS AND METHODS: This was a retrospective comparative study of all cases of genitourinary fistula that underwent curative surgery in two Cameroonian hospitals. Patients were all operated between January 2005 and July 2011 in the gynecology unit of the Maroua Regional Hospital and the University Hospital Centre of Yaoundé by a well-trained surgeon. The characteristics of women with fistulas operated without graft of Martius were compared with those of women operated with graft of Martius. RESULTS: Among the 81 genitourinary fistulas operated, 28 (34.6%) had benefited from graft of Martius. Depending on the characteristics of obstetric fistula, the two groups (that of patients who had a cure with, and that of patients who had a cure without interposition of graft of Martius) were similar: there was no difference in the proportion of rigid edges (89.3% vs. 73.6%, P=0.0989); in the proportion of vaginal flanges (78.6% vs. 60.4%, P=0.0986), in the proportion of cervical localization (42.9% vs. 28.3%, P=0.3762), in the proportion of fistulas with a size greater than 2 cm (64.3% vs. 39.6%, P=0.0702), nor in the proportion of recurrent fistulas (28.6% vs. 41.5%, P=0.2523) between the two groups. Similarly, both groups were comparable according to the results of surgery: there was no difference in the overall closure rate (85.7% vs. 79.2%, P=0.347) nor in the closure of fistula with continence (60.7% vs. 67.9%, P=0.260) between the two groups. The use of graft of Martius had no effect on the overall closure of genitourinary fistula in our series [OR: 1.57; 95% CI: 0.4 to 6.6; P=0.680]. CONCLUSION AND INTERPRETATION: The Martius graft does not seem to affect the outcome of the surgical management of genitourinary fistula. These results need to be confirmed by studies on a larger population.

[Knowledge, attitude and perception about obstetric fistula by Cameroonian women]. / Connaissance, attitude et perception vis-à-vis des fistules obstétricales par les femmes camerounaises Une enquête clinique conduite à Maroua, capitale de la province de l'extrême Nord du Cameroun.

INTRODUCTION: This study seeks to identify what the women who live in Maroua Cameroon know and think about obstetric fistula. POPULATION AND METHOD: It is a single hospital, cross-sectional, descriptive and comparative study. Ninety-nine women in the maternity service of the Maroua Provincial Hospital were interrogated on obstetric fistula between May and July 2005, by enquirers who were trained health agents using a questionnaire which required both closed and open answers. RESULTS: The women who had no previous knowledge of it were generally the illiterate (41.7% compared to 18.8%). More than a third of the women who had an idea of the fistula do not know that there is a surgical treatment for it. Whether they had the previous information on fistula or received it from us, one-tenth of the women suggested that suicide was the solution to fistula where as one-third of the women suggested that a patient suffering from fistula should be isolated. CONCLUSION AND INTERPRETATION: Illiteracy contributes significantly to the lack of knowledge of this affection. The population has a poor perception and a strong negative attitude towards obstetric fistula as they see isolation or suicide as the solution to it.

[Prostaglandin E1--the pharmacologic prosthesis]. / Prostaglandine E1--la prothèse pharmacologique.

The treatment of erectile failure has developed rapidly over the last decade with the introduction of intracavernosal self injection therapy, first with phenoxybenzamine, then with papaverine and paraverine-phentolamine. These drugs are now progressively replaced by prostaglandin E1 mainly because of its efficacy and fewer side effects. Prostaglandin E1 can induce a rigid erection even in case of severe arteriopathy and offers an excellent alternative to a prosthetic implant.

[Inflammatory fibroid polyps of the digestive tract. Apropos of 5 cases]. / Le polype fibroïde inflammatoire du tube digestif. A propos de 5 observations.

Inflammatory fibroid polyp (IFP) is an infrequent condition of the digestive tract which is most often observed in the gastric antrum and ileum. It is known by several synonyms (Vanek tumour, eosinophilic granuloma, etc.) and is sometimes mistaken for eosinophilic gastroenteritis. Its main clinical features are abdominal pain, ulcer-like syndrome, obstruction and/or haemorrhage. It usually runs a benign course and surgery remains the treatment of choice. Its aetiology is unknown. Five cases of gastric IFP are described, one of which was diagnosed from endoscopic biopsies before resection. This is a very uncommon feature which, to our knowledge, has not previously been reported in the literature.