title: [Comparative study of the outcome of surgical management of vesico-vaginal fistulas with and without interposition of the Martius graft: A Cameroonian experience].
abstract: BACKGROUND
  This study aimed to investigate whether Martius' graft has an effect on the outcome of the surgical management of genitourinary fistula.
  
  
  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].
  
  
  CONCLUSIONS
  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.
authors: Service de gynécologie-obstétrique, centre hospitalier et universitaire de Yaoundé, rue de Mellen, BP 1364, Yaoundé, Cameroun; Ligue d'initiative et de recherche active pour la santé et l'éducation de la femme (LIRASEF), Yaoundé, Cameroun; Département de gynécologie-obstétrique, faculté de médecine et des sciences biomédicales, université de Yaoundé I, Yaoundé, Cameroun.
authors: P-M
authors: PM
authors: Tebeu
authors: Service de gynécologie-obstétrique, centre hospitalier et universitaire de Yaoundé, rue de Mellen, BP 1364, Yaoundé, Cameroun; Ligue d'initiative et de recherche active pour la santé et l'éducation de la femme (LIRASEF), Yaoundé, Cameroun; Département de gynécologie-obstétrique, faculté de médecine et des sciences biomédicales, université de Yaoundé I, Yaoundé, Cameroun. Electronic address: fokom.domgue@gmail.com.
authors: J
authors: J
authors: Fokom-Domgue
authors: Ligue d'initiative et de recherche active pour la santé et l'éducation de la femme (LIRASEF), Yaoundé, Cameroun.
authors: G
authors: G
authors: Kengne Fosso
authors: Service de gynécologie-obstétrique, centre hospitalier et universitaire de Yaoundé, rue de Mellen, BP 1364, Yaoundé, Cameroun.
authors: P
authors: P
authors: Tjek Biyaga
authors: Service de gynécologie-obstétrique, centre hospitalier et universitaire de Yaoundé, rue de Mellen, BP 1364, Yaoundé, Cameroun.
authors: J
authors: J
authors: Nelson Fomulu
authors: Geneva Foundation for Medical Education and Research (GFMER), Suisse.
authors: C-H
authors: CH
authors: Rochat
mesh_terms: D002163:Cameroon; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*; D014719:Vesicovaginal Fistula / Q000601:surgery*
keywords: Cameroon; Cameroun; Chirurgie curative; Closure; Continence; Curative surgery; Failure; Fermeture; Fistule génito-urinaire; Genitourinary fistula; Graft of Martius; Greffe de Martius; Échec