Akila Bassowa^1,, Ayoko Ketevi¹, Bernard Douaguibe², Kodjo Fiagnon¹, Samadou Aboubakari³, Koffi Akpadza¹

Introduction: In Togo, the prevalence of FUGI (uro genital fistula iatrogen) as well as the responsibility of the medical staff caring for the patients are unknown because there are very few studies on the subject or the interest to evaluate the share operators in the genesis of this category of fistulas. Purpose: To sensitize the medical opinion on the reality of these medical errors and to improve the care of the patients. Patients and method: This was a retrospective study of 41 cases of iatrogenic fistula collected over 5 years at gynecology service of Sylvanus olympio teatching hospital and Urology departments. The variables studied were the age, the circumstances of the uro genital fistula (FUG), the type of operator, the pathway of the causal intervention of the fistula, the time of diagnosis, the treatment and the correlation between these different parameters. Data processing was done on the IBM® SPSS Statistics software. Values were significant if p <0.05. Results: Caesarean section and hysterectomies were the main causes of uro genital fistula iatrogen. Hysterectomy was the largest provider of fistule uretero vaginal (FUV) with more than half of cases, or 68.29% (28 cases). She was involved in 53.66% of vesico vaginal fistula (FVV) and 9.75% of uretero vaginal fistula (FUV). On the other hand, considering the types of fistulas, FVV were therefore more frequent with caesareans. This category of fistulas was the prerogative of all cadres of obstetric surgeons and gynecologists, both trained operators and established surgeons. Previous pelvic surgery was a significant risk factor. The mean age associated with these lesions was 39.85 years. Conclusion: These results show, like those of other authors, that iatrogenic causes contribute significantly to increasing the number of FUG in Togo. Given the avoidability and severity of fistula, these data on FUGI indicate the urgency of improving surgical training, supervising operators in training especially in low-income countries. FUGI is therefore witnessing a failure of the surgical security system.

Urogenital fistulas, iatrogenic fistulas, fistulas, Lomé (Togo)