Urinary Tract Lesions After Surgery for Gynecological Pelvic Cancers at the Conakry University Hospital

Koundouno Aly Mampan,Toure Aboubacar,Baldé Abdoulaye Korse,Diallo Abdoulaye Bobo,Camara Soriba Naby,Traore Bangaly,Balde Oumar Taibata,Keita Mamady,Camara Fode Lansana,Diakité Saikou Yaya

doi:10.11648/j.js.20200806.19

Abstract

The aim of this study was to describe the urinary complications of surgery for gynecological pelvic cancers and their management at the university hospital in Conakry. Patients and methods: This was a descriptive multicenter study in the main surgical treatment services for gynecological pelvic cancer at the University Hospital of Conakry from 2007 to 2017. Results: Out of 22 cases collected, we found 10 (45.5%) cases during surgery and 12 cases of postoperative complications, including 8 (36.36%) early and 4 (18.18%) late. Direct suture on a ureteral probe in 3 cases and by reimplantation according to the Politano Leadbetter method in 2 cases. Laparotomy fistulorrhaphy was performed in 2 (9.1%) cases of VF. the Latzko technique for 6 (27.3%) other cases of FVV. The 2 cases of FUV were repaired by ureteral reimplantation according to the Lich-Gregoire method. In cases of stenosis, we proceeded to segmental resection followed by suturing on a ureteral probe. The morbidity consisted of: 2 cases of secondary VF, suppuration, 2 urinary incontinence, Operative mortality was 3 (13.6%) cases. Conclusion: The prevention of these lesions is the best way and requires a good knowledge of the anatomy and the surgical techniques. Early diagnosis of gynecologic pelvic cancer is necessary to minimize surgical risks.

Highlights

Ureteral and bladder lesions are the main urinary complications after radical surgery for cervical cancer [1]. This is a significant problem facing urologists, gynecologists, general surgeons and oncologists. These lesions are explained by the close anatomical relationships between the urinary and genital systems in women, when these normal anatomical relationships are modified on the one hand and on the other hand the involvement and invasion of these organs by cancer
Eisenhauer et al [4] reported 3.5% of urological complications while bladder lesions represented 2 to 3% according to Bernard [5]
Several authors are unanimous on the occurrence of urinary complications after surgery for gynecological pelvic cancers in the departments of gyneco-obstetrics, UrologyAndrology, general surgery and Oncological Surgery [1, 2]

Summary

Introduction

Ureteral and bladder lesions are the main urinary complications after radical surgery for cervical cancer [1]. This is a significant problem facing urologists, gynecologists, general surgeons and oncologists. These lesions are explained by the close anatomical relationships between the urinary and genital systems in women, when these normal anatomical relationships are modified on the one hand and on the other hand the involvement and invasion of these organs by cancer. The complications are directly related to the extent of the associated excisional operations They are dependent on the context where the gesture is performed. Diallo et al reported 5.3% urological complications after radical hysterectomy

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Conclusion