title: [Some reflections on the classification of African obstetric fistulas].
abstract: While the English-speaking world may have reached a consensus about Kees Waaldjik's classification of obstetric fistulas, no unanimity around this classification exists among French-speaking medical workers. The objective of this review is to propose a classification, based on long experience in the care of these women, by setting up a comparison with Waaldjik's. Our classification takes two criteria into account: (1) the environment of the fistula, that is: (a) fistula with a soft (relatively unscarred) vagina, b) fistula with vaginal sclerosis (bands or adhesions, vaginal stenosis or atresia), (c) vesicovaginal fistula associated with a (high or low) rectovaginal fistula or perineal lacerations (first, second or third degree); (2) the anatomical site of fistula, of which there are five types: (a) type I: fistula of the vesicovaginal wall, (b) type II: vesico-cervico-urethral fistula, with two major subgroups: type IIA (without destruction of the urethra) and type IIB (with destruction of the urethra), type IIA being subdivided in three subgroups: IIAa, IIAB and cIAI, (c) type III fistulae trigono-Neck utero-vaginal, (d) type IV: complex mixed fistula, (e) type V, high fistulas: the vesico-cervical-uterine fistula and classical vesicouterine.
  
  
  CONCLUSIONS
  Our classification is simple, not simplistic, with some resemblance to that of Waaldjjik.
authors.affiliation: Service urologie CHU Point G, faculté de médecine et d'odontostomatologie, 333 Bamako, Mali.
authors.forename: M L
authors.initials: ML
authors.lastname: Diakité
authors.affiliation: Service urologie CHU Point G, faculté de médecine et d'odontostomatologie, 333 Bamako, Mali.
authors.forename: K
authors.initials: K
authors.lastname: Ouattara
authors.affiliation: Service urologie CHU Point G, faculté de médecine et d'odontostomatologie, 333 Bamako, Mali.
authors.forename: A
authors.initials: A
authors.lastname: Tembely
mesh_terms: D000349:Africa; D005260:Female; D006801:Humans; D014624:Vaginal Fistula / Q000145:classification*
keywords: Mali; classification; obstetric fistula; treatment