Abstract
Objective: To assess the management of urological complications (UC) in gynecological cancer (GC) surgery at the Centre Hospitalier Universitaire de Conakry. Patients and method: Retrospective and descriptive multicenter study of UC occurring in patients operated on for GC from 2007 to 2016. Complications were defined as urinary tract lesions and vesico-sphincteric disorders. Results: We found 57 (20.5%) UC in 278 patients operated on for cervical 51 (89.5%), ovarian 5 (8.8%) and vaginal 1 (1.8%) cancers. These complications were urinary tract lesions observed intraoperatively in 9 cases (15.8%) and postoperatively in 10 cases (17.5%), and functional disorders in 38 (66.7%). The intraoperative lesions were 7 bladder wounds repaired by suture, and 6 complete ureteral sections of which 4 were anastomosed and 2 repaired by ureterovesical reimplantation. Postoperatively, there were 6 vesicovaginal fistulas treated by fistulorraphy, 2 uterovaginal fistulas repaired by uterovaginal reimplantation, and 1 ureteral stenosis treated by segmental resection followed by suture. Functional disorders included urine retention 31 (54.4%) and urinary incontinence 7 times (12.3%). Sphincter rehabilitation 17 cases (29.8%), repeated bladder catheterization 32 cases (56.1%), and vitamin B1 injection or oxybutynin 30 cases (52.6%) achieved remission of these disorders in 31 (81.6%) cases. Conclusion: Early diagnosis of GCs and careful dissection during pelvic surgery can reduce the frequency of these urologic complications in our practice. Key words: Gynecological cancers surgery, urological complications
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