Epidemiologie du prolapsus genital

La genèse du prolapsus génital est multifactorielle et des évènements individuels vont influencer l’apparition du prolapsus chez la femme. L’étude du profil épidémiologique des femmes victimes de prolapsus génital permet d’étudier tous les facteurs pour mieux conseiller et rassurer les femmes dans la prévention et la prise en charge de cette pathologie.Objectifs. Déterminer le profil épidémiologique des patientes victimes de prolapsus au service de gynécologie de l’hôpital du Mali.Matériel et méthode. Il s’agissait d’une étude transversale à visée descriptive à collecte prospective du 1er janvier au 31 décembre 2019. Nous avons inclus tous les cas de prolapsus génital diagnostiqué en dehors de la grossesse et dans les trois premiers mois du post-partum. L’interrogatoire a permis de préciser le moment d’apparition et l’examen physique d’identifier le type du prolapsus.Résultats : Nous avons enregistré 35 cas de prolapsus sur 267 interventions chirurgicales soit 13,10%. Les patientes en âge de procréer étaient de 21 (60%) versus patientes en ménopause 14 (40%). L’âge moyen était de 44,74 ans avec des extrêmes de 17 et 80 ans, La majorité des patientes était des femmes au foyer 29 cas (82,86%). Le milieu de résidence était rural ou urbain dans respectivement 20 cas (57,14%) et 15 cas (42,86%). La parité moyenne était de 5,22 % avec 45,71% de grandes multipares, 25,71% de paucipares et 20% de multipares. Les femmes mariées ont représenté 65% des cas. La durée d’apparition du prolapsus était en moyenne de trois ans. Les principaux antécédents retrouvés étaient la macrosomie 2 cas (5,71%), la déchirure du périnée 2 cas (5,71%) et la césarienne 1 cas (2,86%). Selon la classification de Baden, 23 patientes avaient un prolapsus de grade 3 (65,71%). Les organes participant au prolapsus étaient l’utérus et la vessie simultanément dans 19 cas (54,29%), la vessie seule dans 6 cas (17,14%), la vessie et le rectum 4 cas (11,43%).Conclusion : le prolapsus génital est fréquent chez la multipare avec une prédominance du grade 3 English title: Epidemiology of genital prolapse The genesis of genital prolapse is multifactorial and individual events will influence the onset of prolapse in women. The study of the epidemiological profile of women victims of genital prolapse makes it possible to study all the factors to better advise and reassure women in the prevention and management of this pathology.Goals. To determine the epidemiological profile of patients suffering from prolapse in the gynecology department of the hospital in Mali.Material and method. This was a descriptive cross-sectional study with prospective collection from January 1 to December 31, 2019. We included all cases of genital prolapse diagnosed outside pregnancy and in the first three months postpartum. The questioning clarified the time of onset and the physical examination identified the type of prolapse.Results: We recorded 35 cases of prolapse out of 267 surgical procedures, (13.10%). Patients of childbearing age were 21 (60%) versus menopausal 14 (40%). The mean age was 44.74 years with extremes of 17 and 80 years. The majority of patients were housewives in 29 cases (82.86%). The place of residence was rural or urban in respectively 20 cases (57.14%) and 15 cases (42.86%). The average parity was 5.22% with 45.71% large multiparas, 25.71% pauciparas and 20% multiparas. Married women accounted for 65% of cases. The duration of the onset of prolapse was on average three years. The main antecedents found were macrosomia 2 cases (5.71%), perineum tear 2 cases (5.71%) and cesarean section 1 case (2.86%). According to Baden's classification, 23 patients had grade 3 prolapse (65.71%). The organs participating in the prolapse were the uterus and bladder simultaneously in 19 cases (54.29%), the bladder alone in 6 cases (17.14%), and the bladder and rectum in 4 cases (11.43%).Conclusion: genital prolapse is frequent in multipara with a predominance of grade

Medical-Grade Honey Enhances the Healing of Caesarean Section Wounds and Is Similarly Effective to Antibiotics Combined with Povidone-Iodine in the Prevention of Infections—A Prospective Cohort Study

Caesarean sections (CS) are becoming increasingly popular. The antibiotic resistance crisis and relentless risk of infections, especially in developing countries, demand alternative treatment options. Medical-grade honey (MGH) exerts antimicrobial and healing properties. This study aims to evaluate the effect of MGH treatment on CS wound healing and postoperative complications when compared to conventional treatment (antibiotics in combination with povidone-iodine). In this prospective cohort study, 766 CS patients were included and evenly divided into two groups. The treatment group (n = 383) received an MGH-based formulation (L-Mesitran Soft) and the control group (n = 383) received antibiotics (Amoxicillin) combined with povidone-iodine. The wound healing time and complication rate were determined for both groups, and subsequently, predisposing factors for complications among the baseline characteristics and non-patient-related parameters were determined. The baseline characteristics were similar for both study groups, supporting a homogenous distribution. Postoperative complications were experienced by 19.3% of the patients in the control group and 18.8% in the treatment (MGH) group. The treatment group experienced significantly more superficial pus discharge than the control group, while the latter experienced significantly more deeper pus discharge. BMI, age, duration of hospitalization, anesthesia, and duration of CS could affect the complication risk. MGH significantly enhanced wound healing until day 42. On average, the healing time with MGH was 19.12 ± 7.760 days versus 24.54 ± 8.168 days in the control group. MGH is a potent alternative treatment to antibiotics and povidone-iodine because while the complication risk is similar, MGH has additional benefits. MGH promotes wound healing and does not bear the risk of resistance

Fertility after Endoscopic Surgery for Ectopic Pregnancy Management in Point "G” Teaching Hospital, Bamako-Mali

Endoscopic surgery of ectopic pregnancy is actually the gold standard for the management of fallopian tubal diseases. A survey was conducted to evaluate fertility in patients who underwent endoscopic management for ectopic pregnancy. A retrospective study was conducted at the department of general and endoscopic surgery of the Point "G" teaching hospital, in Bamako, Mali, from January 1st 2007 to December 31, 2016. Forty-eight (48) patients who underwent endoscopic management of tubal ectopic pregnancy and who have been followed up for fertility were included in this study. Statistical tests used were X2 or Fisher test and their confident interval, p<1 % has been considered as statistically significant. The therapeutic score of Pouly was less than 4 in 25.0% (n = 12). The return to fertility was observed among 48.0% of patients (n = 23). The chance of conception was less than 80.0% after the fourth postoperative year (p=0.001). The outcome of pregnancies has been seventeen full-term pregnancies, three ectopic pregnancies and three miscarriages. The occurrence of pregnancy after endoscopic management indicated for ectopicpregnancy is possible. However, many factors can influence the future conception. Keywords: Extra-uterine pregnancy, tubal abnormality, endoscopic management, Mal