[Epidemiological, aetiological and treatment aspects of obstetrical fistula in Togo].

Objective: To appreciate and to analyse the different human and materials capacities available for management in view of its total eradication.

Patients And Methods: From January 2001 to December 2005, a census of obstetrical urogenital fistulae was carried out from treatment cases notes in all the hospitals of Togo. It was a retrospective and descriptive study which included the age of the patients, the situation of the sanitary institution, the quality of the physician in charge of the obstetrical fistulae, information about the kind of the fistulae, the way in which the delivery was done and the financial incidence for the repair of the fistulae. The subject of the study, the confidentiality on the contents of the case notes and the results expected were clarified to the responders.

Results: One hundred and sixty-three (163) cases of obstetrical fistulae were studied. The average age was 21 years (extremes: 15 and 45). Forty-four sanitary institutions comprising 93 treatments service were visited. Hospitals were noted to be far away from patients in the north of the country. All the four hospitals able to take care of obstetrical fistulae effectively were located in the south. Eight hundred and forty health personals were questioned and 467 (55.60%) had said to be able to make the diagnosis of obstetrical fistula. A maximum of four surgeons were trained and competent to manage obstetrical fistula. Operating equipment of obstetrical fistula was inexistent in 40 hospitals, that is 90.90%.

Conclusion: Obstetrical fistula is present in Togo and represents a public health problem to eradicate. It is more frequent in young women from rural areas and of low educational level. It constitutes also a handicap for the reproduction of humankind.