Introduction: Abnormalities of sexual differentiation are conditions due to various congenital or hormonal etiologies. The aim of our study was to describe the clinical aspects of sexual differentiation abnormalities in the department of medicine and endocrinology. Methodology: Our study was retro-prospective and descriptive ranging from September 2011 to July 2021 (i.e. 10 years), carried out in the Medicine and Endocrinology department of the Mali Hospital. Results: Ten patients out of 8213 consultants were collected, representing a hospital frequency of 0.12%. Six (6) of them were of female phenotype, and 2 of male phenotype. The average age was 21.71 years with extremes ranging from 17 days to 46 years. Clinically, patients with a female phenotype presented an anomaly of the external genitalia (5/10), axillary and pubic hypopilosity (6/10), delayed puberty (5/10), primary amenorrhea (5/10), and the presence of a bilateral inguinal mass (2/10). For patients with a male phenotype (2/10); bilateral gynecomastia (2/10), macroskelia (1/10) with wingspan of 197cm, axillary and pubic hypopilosity (1/10), an anomaly of the external genitalia (2/10). Conclusion: anomalies of sexual differentiation, although relatively rare, exist in Mali and throughout the world.

Introduction: Glycated haemoglobin is considered an objective element in monitoring glycaemic control in diabetic patients. High-performance liquid chromatography (HPLC) is the reference method for measuring HbA1c. However, even this method can be affected by certain conditions such as anemia. Purpose: To study the impact of anaemia on the measurement of glycated haemoglobin levels by HPLC in diabetic patients. Methodology: We conducted a prospective, descriptive and comprehensive study from November 2022 to April 2023, on 06 months at the Mali Hospital, measuring glycated haemoglobin, blood glucose and haematological parameters (CBC). Results: We included 71 diabetic patients, 42.3% were men and 57.7% women. In our study population, 33.8% were anaemic, among them 16.9% were women and 16.9% men. The age group [50-80] years constituted the majority (n = 14) of anaemic patients. The most common type of anaemia in our diabetic patients was normocytic anaemia. HbA1c >7% was found in 91.6% (n=22) of our anaemic patients. The mean haemoglobin level was not statistically significantly different from the HbA1c level (P = 0.0595). There was a statistically significant difference between MCHC and HbA1c (P = 0.04). To our knowledge, we did not observe any significant impact of anaemia on the measurement of HbA1c by the HPLC method. Conclusion: Our study showed a high frequency of normocytic anaemia in diabetic patients. We also noted that the reliability of HPLC in measuring HbA1c was not affected by a minor decrease in total haemoglobin levels.

Background Epilepsy remains a significant public health concern in Sub-Saharan Africa (SSA) where diverse etiological factors contribute to its prevalence. Among these factors are conditions originating from the neuroectoderm, such as tuberous sclerosis. Insufficient medical attention and a lack of comprehensive multidisciplinary care contribute to its under-recognition. Materials and methods We conducted a retrospective descriptive study, involving 12 patients admitted to the neurology and pediatric departments of the University Hospital Ignace Deen between 2010 and 2022 due to recurring epileptic seizures. Subsequently, these patients were diagnosed with Tuberous sclerosis using the Schwartz 2007 criteria. The aim of this study is to reassess this condition from a clinical and paraclinical point of view in a tropical environment. Results Tuberous sclerosis, also known as Bourneville disease, was diagnosed in 12 patients exhibiting focal motor seizures and complex focal seizures likely associated with cortical and subcortical tubers detectable by EEG and neuroimaging, including CT and MRI. Delayed treatment resulted in varying degrees of mental decline. Additionally, some patients displayed cardiac hamartomas and intracranial posterior and anterior aneurysms as minor diagnostic indicators. Conclusion The study reveals a consistent clinical presentation accompanied by deteriorating neurological and psychological symptoms attributed to delayed multidisciplinary management. These findings are utilized to assess therapeutic strategies and prognostic outcomes.

•Stroke is a major public health problem, and the etiological aspects are poorly studied and documented because of under-medicalization.•The syphilitic etiology was confirmed in six (6) patients with a mean age of 43 years (extremes 36 and 49 years).•The clinical picture was dominated by carotid syndromes: superficial and deep sylvian syndrome, anterior cerebral artery syndrome and vertebro-basilar syndromes and one case of lacunar syndrome.•The diagnosis was based on the positivity of serological reactions (VDRL-TPHA) in blood and cerebrospinal fluid (CSF) and the presence of hypercellularity with predominantly lymphocytic pleiocytosis and hyperproteinorachy in the CSF in the absence of any other etiologies.

Introduction: Despite scientific progress in the fields of anesthesia and surgery, caesarean section is still not a harmless procedure. The aim of this study was to report the post caesarean section complications received in the general surgery department of the Ignace Deen National Hospital at the University Hospital of Conakry. Materials and Methods: It this was an observational, cross-sectional and descriptive study of six (6) months (January 1 , 2021 to June 30, 2021) in the general surgery department of the Ignace Deen National Hospital, CHU of Conakry. The socio-demographic and therapeutic variables were studied. Results: We collected 31 cases of postoperative complications among women in the department, of which 19 cases were post cesarean sections (61.29%). The age group from 20 to 39 years most affected (63.2%, n=12). The average age was 28.79 years. Most caesarean sections were performed in peripheral structures (private health centers, municipal centers and prefectural hospitals (73.7%, n=14) and 26.3% of cases, n=5) took place at the maternity hospital of the CHU. Operators - were residents in gynecology-obstetrics (42.1% n=8) and general practitioners acting as obstetrician-gynaecologists (36.8% n=7). Generalized acute peritonitis and surgical site infections were the most observed complications with 42.1% (n=8) and 26.3% (n=5). Iatrogenic colonic and bladder wounds were noted. The surgical procedures performed were visceral trimmings and sutures followed by peritoneal cleansing with drainage (53.8% (n=7). The outcome was 100% favorable (n=19) with an average hospital stay of 14 days. Conclusion: Post cesarean complications were frequent among the surgical complications referred to our department. Acute generalized peritonitis and surgical site infections ranked first. The care was medical surgical. The follow-up was favourable. Hope lies in prevention through appropriate pregnancy monitoring measures and planning for a safe caesarean section.

Purpose: A child’s growth reflects it nutritional and pubertal status and it is proven that nutrition is a factor affecting pubertal development. Sickle cell patients often have slowed growth and delayed pubertal development. This work aims to assess the nutritional and/or pubertal profile in children with sickle cell diseases (SS) admitted at the CEMECO center. Materials and methods: This was a cross-sectional study and study participant under 16 years were randomly selected from the health center database having about 6497 cases and enrolled in the study.The participants were divides into two groups based on the electrophoresis of hemoglobin: Sickle cell disease including 103 cases of SS (homozygote) and 18 cases of SC, S, β-Thalassemia and SE (heterozygous). While the group of non-sickle cell participants includes 87 (AA and AS) Results: We included 208 children among them121 sickle cell disease patients and 87 non sickle cell diseasechildren. with a sex ratio M/F was about1.02. The meanage of sickle cell patients was 8.7±4.4 years while that of non-sickle cell patients was 9.5 ± years. The family income evaluated according to the MICS, was similar between the two groups (P= 0.123). Evaluation of nutritional status using the weight / height score-z, revealed that in children under five years of age with sickle cell patients, was lower than that of non-sickle cell patients(p=). However, the difference was not significative (P = 0.155). The height/age ratio express as Z score showed a significative difference between sickle cell patients (1.1 Z score)while non-sickle cell patients (P =0.000). Underweight evaluated by weight/age z-score showed that the in-sickle cell patients were -0.91 and -0.12 in non-sickle cell patients (P=0.014). However, the BMI evaluation did not show any significant difference between sickle and non-sickle cell patients P=0.188. The proportion of delayed puberty in sickle cell patients were (4.8%) compared to 6.3% in non-in sickle cell patients. puberty. Uni-variate analysis showed an association between sickle cell disease and testicular development (P=0.046). Conclusion: The height/age ratio expressed as Z score result is similar to those found by Sharon E. Cox et al. in Tanzania in 2011. Contrary to the report by Al Saqladi et al, a difference was found in the weight/age z-score between the body mass index in control children compared to sickle cell children. These results are different from those found by Shongo et al. in 2015 that were statistically significant with a P >0.05 (21). This difference may be justified by the fact that our sample was larger than theirs. In some, this study highlighted growth retardation and slowed testicular development in children with sickle cell disease. The authors do not declare any conflict of interest

Purpose: A child’s growth is a reflection of it nutritional and pubertal status and its proven that nutrition is a factor affecting pubertal development. Sickle cell patients often have slowed growth and delayed pubertal development. This work aims to assess the nutritional and/or pubertal profile in children with sickle cell diseases (SS) admitted at the CEMECO center. Materials and methods: This was a cross-sectional study and study participant under 16 years were randomly selected from the health center database having about 6497 cases and enrolled in the study.The participants were divides into two groups based on the electrophoresis of hemoglobin: Sickle cell disease including 103 cases of SS (homozygote) and 18 cases of SC, S, β-Thalassemia and SE (heterozygous). While the group of non-sickle cell participants includes 87 (AA and AS). Results: We included 208 children among them121 sickle cell disease patients and 87 non sickle cell diseasechildren. with a sex ratio M/F was about1.02. The meanage of sickle cell patients was 8.7±4.4 years while that of non-sickle cell patients was 9.5 ± years. The family income evaluated according to the MICS, was similar between the two groups (P= 0.123). Evaluation of nutritional status revealed that in children under five years of age, the weight / height index z-score of sickle cell patients (-0.82 ± 1.1 [-3.01-1.62]) was lower than that of non-sickle cell patients (-0.29 ± 1.4Zscore {-2.91-2.86]). However, the difference was not significative (P = 0.155).The height/age ratio express as Z score showed a significative difference between sickle cell patients (1.1 Z score)while non-sickle cell patients (-0.2 Z score) (P =0.000). Underweight evaluated by weight/age z-score showed that the in-sickle cell patients were -0.91 and -0.12 in non-sickle cell patients (P=0.014). However, the BMI evaluation did not show any significant difference between sickle and non-sickle cell patients P=0.188. The proportion of delayed puberty were 4 (4.8%) in sickle cell patients compared to 6.3% in non-in sickle cell patients. puberty. Uni-variate analysis showed an association between sickle cell disease and testicular development (P=0.046). Conclusion: The results of our study highlighted growth retardation and slowed testicular development in children with sickle cell disease. The authors do not declare any conflict of interest

INTRODUCTION:Hyperprolactinemia, which is a supra-physiological secretion of prolactin, is the most common anterior pituitary disorder encountered in clinical practice. Its incidence and prevalence are poorly defined in Africa and the rest of the world. The objectives were to study the clinical, paraclinical, etiological and therapeutic aspects of hyperprolactinemia at the Mali hospital.METHODOLOGY:This was a 5-year cross-sectional study. Data collection was retrospective (July 2011 to October 2015) and prospective (December 2015 to July 2016).RESULTS:We collected 37 cases of hyperprolactinemia. The sex ratio was 0.85. The average age was 37.32 years with extremes ranging from 15 to 74 years. The clinical picture was dominated in women by amenorrhea (80%), galactorrhea (70%), headache (55%), hypofertility (50%), visual disorders (25%) and in men by decreased libido (64.7%), gynecomastia (47.1%), headache (47.1%), visual disorders (41.2%) and erection disorders (29.4%). Basal prolactinemia was greater than 100ng/ml in 45.9% of patients. Cerebral CT had objectified: 11 cases of macroadenomas and 5 cases of pituitary microadenomas. The main causes of hyperprolactinemia were: prolactin pituitary adenoma (43.24%); hypothyroidism (5.40%) and estrogen-progestin use in 5.40%. For treatment, 64.9% of patients were placed on cabergoline; 27% on bromocriptine and 8.10% on simple clinical and biological monitoring.CONCLUSION:Hyperprolactinemia is a condition that exists in our health care facilities. Clinicians should consider this in the face of galactorrhea amenorrhea or decreased libido. It is also necessary to improve the technical platform for better care.

Objective: Azoospermia is one of the most important causes of couple infertility.The objective of our study is to report the clinical-biological profile of the azoosperm patient to the Urology-Andrology Department of the Conakry University teaching Hospital.It aims to take stock of the diagnostic management of azoospermia at this time where the world scientific community seems to be turned towards the intracytoplasmic sperm injection in the treatment of men with severe spermiological dysfunction.Patients and Method: This was a descriptive retrospective study lasting 12 months from January 1 to December 31, 2015.It collected 151 patients out of a set of 544 follow-ups for desire to have children.Were included the patients whose files contained all the information of the clinical observation (general information, reason for consultation, evolution, history, data of the physical examination) and a paraclinical assessment consisting of the FSH level and two spermograms spaced three months, confirming the diagnosis of azoospermia.Results: The mean age was 36.4 years with extremes of 23 and 56 years old.Urogenital infections (36.4%) followed by a notion of inguinal surgery had been the main patients' history.Primary infertility accounted for 76.8% of cases.The mean duration of infertility was 6.5 years with extremes of 2 and 19 years.Azoospermia affected 27.76% of patients who consulted for the desire to have a child.It was judged secretory in 59.6% of cases, excretory in 25.8% of cases, and undetermined in 14.6% of cases.Varicocele was the main associated abnormality (46.3%) followed by testicular hypotrophy (36.4%).Neisseria Gonorrhoeae was the most common germ in sperm culture (21.7%).Chlamydia serology was positive in 21.7% of patients.Conclusion

The objective of the study was to report the results of the surgery of the Vesico-vaginal fistula (VVF) transection types at CHU Conakry.Methods: This was a prospective descriptive study that focused on 64 patients operated for VVF transection type at the Urology department of CHU Conakry between January 2013 and December 2015.Four types of transection were defined according to the state of the urethra and vagina, the size of the fistula, the peri-fistulous tissue and associated lesions.The variables studied were the proportion of transection, age, the type of transection, the number of previous cures, the operative technique, the complications and the results after a follow-up of 3 months.Results: Transection accounted for 47.05% of the obstetric fistulas.The average age was 25.18 years old (14-43 years old).This was a Type I transection (11 cases), type II (27 cases), type III (19 cases) and type IV (7 cases).The surgical approach was vaginal in 64 cases.Fistulorraphy with a confection of a new cervix and cervico-urethral anastomosis was conducted in 19 patients, combined with bladder flap urethroplasty (30 patients) or vaginal flap (15 others).We recorded healing in 37 cases.Conclusion: Transection type VVF is a severe VVF.The preferential surgical approach was vaginal.Technical difficulties were related to associate lesions and the continence system affected.

L’automutilation genitale est un phenomene rare en pratique urologique. L’objectif de ce travail etait de rapporter un cas clinique d’autoamputation totale des organes genitaux externes (OGE) chez un patient âge de 32 ans, celibataire dans un contexte de delire psychiatrique. Avec une revue de la litterature, nous avons rappele les circonstances dans lesquelles surviennent les automutilations genitales et les principes de prise en charge des malades. Mots-cles : automutilation, genitale, prise en charge.

Décrire les caractéristiques épidémiologiques et cliniques des goitres multinodulaires toxiques au sein du service de médecine et d’endocrinologie de l’hôpital du Mali. Étude rétrospective et descriptive menée à partir des dossiers des patients, recensés de septembre 2011 à septembre 2015. Cent dix-neuf patients ont présenté un GMNT (19,83 % sur 600 patients en dysthyroïdie). Il y avait 106 femmes (89,1 %) et 13 hommes (10,9 %) sex-ratio = 0,12. L’âge moyen était de 44 ± 14 (25–80) ans. La durée moyenne d’évolution du goitre était de 2–3 ans (26,9 %). Les signes cliniques les plus retrouvés étaient l’amaigrissement (65,5 %), la nervosité (52,1 %) et l’insomnie (52,1 %), et 64 patients avaient une hyperthyroïdie infraclinique (53,8 %). Les signes de compression étaient présents chez 18 patients (14,4 %). Les adénopathies cervicales étaient présentes chez 5 patients (4,2 %). L’hyperthyroïdie était confirmée par une TSH basse chez tous les patients. L’échographie réalisée a permis de retrouver des nodules calcifiés (22,85 %) et kystique (12,38 %) rendant suspect avec la nature bénigne ou maligne de ces nodules. Le GMNT a été retrouvé chez 19,83 % des patients, le sex-ratio était de 0,12 avec un âge adulte avancé. Les signes de compression ont été retrouvés chez quelque patient. Les adénopathies étaient présentes chez 5 patients faisant évoquer un cancer de la thyroïde. Intérêt du score de TIRADS et de cytologie pour une prise en charge efficiente.

Le syndrome de Klinefelter (SK) regroupe l’ensemble des manifestations cliniques et hormonales liées à un caryotype XXY.C’est une cause génétique majeure d’infertilité assez fréquente touchant 11 % des hommes atteints d’azoospermie. Patient de 28 ans, militaire des nations unies, célibataire, sans antécédents personnels particuliers, référé pour gynécomastie bilatérale indolore associé à un trouble de l’érection, une baisse de la libido et une voie efféminée. À l’examen physique gynécomastie bilatérale (Tanner S3) souple indolore à la palpation sans nodule ni de galactorrhée ; présence d’une pilosité au niveau des aisselles et du pubis (P1) ; absence de barbe. Les testicules ont une taille de 2 mL à l’orchidomètre de Prader ; aspect eunuchoïde : taille : 170 cm – envergure : 181 cm. Le diagnostic du SK fut posé devant un hypogonadisme hypergonadotrope FSH : 44,49 mUI/mL ; LH : 29,37 mUI/mL ; testostérone : 1,86 ng/mL ; estradiol : 0,5 Pg/mL ; hypospermie et une azoospermie au spermocytogramme. L’étude cytogénétique a conclu à un caryotype 47, XXY. L’échographie testiculaire : atrophie testiculaire bilatérale, 3 mL à droite et 2 mL à gauche. Sur le plan thérapeutique, le malade a bénéficié de la réduction mammaire par chirurgie plastique et fut mis sous Androtardyl® 250 mg en injection intramusculaire tous les mois. La majorité des SK sont dépistés lors de l’enrôlement dans l’armée mais l’installation insidieuse des signes peut en retarder le diagnostic.

Étudier les différentes affections endocriniennes dans le service de médecine/endocrinologie de l’hôpital du Mali. Étude transversale, descriptive de 3 ans et 3 mois avec recueil rétrospectif des données à partir des dossiers de consultation et d’hospitalisation. Test de χ2 utilisé avec seuil de significativité p < 0,05. Prévalence hospitalière des endocrinopathies : 58,1 %. Âge moyen : 41,32 ans. Prédominance féminine sex-ratio : 0,36. Surpoids et obésité (36,4 %) : prédominance de l’obésité chez la femme après 20 ans (p < 0,01). Complications associées : HTA (54,26 %) ; diabète (34,51 %) ; dyslipidémie (31,22 %). Diabète (36 %) : DT2 (65,9 %) ; DT1 (25,1 %) ; céto-acidose (14 %). Évolution en hospitalisation rémission (77,35 %), décès (8,65 %), sortie contre avis médical (14 %). Affections thyroïdiennes (26 %) : hyperthyroïdie (55 %) ; goitre euthyroïdien (37 %) ; hypothyroïdie (8 %). Évolution : perdue de vue (62,3 %), rémission (33,3 %), rechute (3,1 %), décès (1,2 %). Affections surrénaliennes (0,6 %) : insuffisance surrénale aiguë (61,9 %) ; hypercorticisme (14,3 %) ; insuffisance surrénale lente (14,9 %) ; phéochromocytome (9,5 %). Évolution : rémission (61,9 %), décès (14,3 %). Affections gonadiques (0,5 %) : hypogonadisme (44,4 %) ; virilisation féminine (33,3 %) ; puberté précoce (11,1 %) ; hyperœstrogénie testiculaire (5,9 %) et syndrome du testicule féminisant (5,9 %). Affections hypophysaires (0,3 %) : adénome hypophysaire (63,6 %) ; syndrome de Sheehan (5,9 %) ; diabète insipide (5,9 %), craniopharyngiome (5,9 %). Affections parathyroïdiennes (0,2 %) : hypoparathyroïdie (66,6 %) avec 50 % des cas iatrogéniques. Hyperparathyroïdie (16,6 %) ; hypercalcémie paranéoplasique (16,6 %). Les endocrinopathies sont fréquentes à l’hôpital de Mali. Cependant, le suivi à long terme reste problématique du fait des ressources limitées.

Le cancer du rectum a une incidence estimée à 30 000 cas par an dans les pays développés, avec une survie globale de 55% à 5 ans. Les techniques d’imagerie moderne, désormais disponibles au Sénégal pourraient permettre de mieux poser les indications thérapeutiques de cette affection dans les pays en voie de développement, en précisant notamment les critères de résécabilité. Les auteurs ont colligé sur 20 mois 32 dossiers d’IRM de patients atteints de cancer du rectum; les examens ont été réalisés sur un aimant de 1,5 Tesla. La marge circonférentielle et la marge distale ont pu être prédites chez 16 patients parmi les 17 adressés pour bilan pré-thérapeutique, confirmant l’IRM comme outil performant pour déterminer les critères de résécabilité.

OBJECTIVE:To analyze the management of obstetric vesico-vaginal fistula in the three sites of Engender Health in Guinea.PATIENTS AND METHODS:It was a retrospective study of descriptive type having helped collect 450 cases of vesico-vaginal fistulas in three support sites engender health between January 2008 and December 2011. The variables studied were epidemiological, clinical and therapeutic reasons and treatment outcomes were evaluated after a decline of at least six months.RESULTS:The mean age of onset of the fistula was 25years, ranging from 12 to 55years and 58.8% (n=265) of patients were aged between 18 and 30years. The mean duration of fistula was 11years, ranging from 1 to 38years. Eighty-two percent (n=416) of patients were housewives and 66.4% (n=299) off school. The complex fistula with 66% (n=297) was the most frequent. The treatment consisted of a fistulorraphie after splitting vesico-vaginal in 93.3% (n=420) of cases. Therapeutic results considered after a mean of 8months have resulted in a cure in 79.3% (n=357) of cases, improvement in 4.2% (n=19) of cases and failure in 16 4% (n=74) of cases.CONCLUSION:Vesico-vaginal fistula is a major cause of maternal morbidity in Guinea. The establishment of a real health policy based on sound medical and social structures contributes to its eradication.LEVEL OF EVIDENCE:5.

OBJECTIVEThis research aimed to analyze the epidemio- clinical characteristic and the prognosis of patients with eclampsia admitted to the intensive care unit at the University Hospital of Point G.MATERIALS AND METHODSThe clinical records of all patients admitted to intensive care for eclampsia from September 2009 to February 2011 were retrospectively collected. We analyzed the following parameters: age, parity, gravidity, the admission deadline, the beginning of eclampsia compared to the term of pregnancy, the number of seizure, mode of delivery, score of Glasgow, blood pressure, proteinuria, complications and evolution.RESULTSAmong 702 admissions, 158 patients, with a mean age of 20 ± 4 were hospitalized for eclampsia (22.5%). We recorded 106 cases of first pregnancies (67.1%) and 104 primiparous (65.8%). The admission period after the first seizure was over 6 hours for 90 patients (57%). The first seizure had occurred in ante-partum period for 69 patients, in per-partum period for 4 patients and in postpartum period for 85 patients.Ninety-three patients (59%) had consciousness disorders at admission, 12 patients received oxygen treatment .Vaginal delivery was the mode of delivery for 93 patients and cesarean section for 65 patients.Eclampsia was associated with renal failure in 25 patients, HELLP syndrome for 15 patients, the stroke for 5 patients, acute pulmonary edema for 3 patients, the coagulation disorders for one patient; and the sepsis for 6 patients. Maternal and perinatal lethality was 9.5% and 10.8% respectively.CONCLUSIONEclampsia is a frequent medical and obstetric emergency in intensive care unit of the University Hospital of Point G and affects young patients during their first pregnancy and delivery. Maternal and perinatal lethality remains high, due to the delay in the cases management and the associated factors of gravity. Strong actions are needed to raise awareness for early medical visit and to prepare medical teams for better cases management.

Le but de l’étude était de rapporter la chirurgie de la fistule vésicovaginale (FVV) à type transsection au service d’urologie andrologie du CHU de Conakry. Il s’agissait d’une étude rétrospective de type descriptif ayant porté sur 64 patientes opérées pour FVV à type de transsection au service d’urologie andrologie du CHU de Conakry entre le 1er janvier 2013 et le 31 décembre 2015. Quatre types de transsection ont été définis selon l’état de l’urètre et du vagin, la taille de la fistule, le tissu péri-fistuleux et les lésions associées. Les variables de l’étude étaient la proportion de la transsection par rapport aux autres fistules, l’âge, le type, le nombre de chirurgie réparatrice antérieure, la technique, les complications et les résultats après un suivi de 3 à 6 mois. La transsection a représenté 47,05 % de l’ensemble de fistules obstétricales. La moyenne d’âge de nos patientes était de 25,18 ans (14–43 ans). L’accouchement était par voie vaginale dans 75 % des cas et à domicile dans 53,10 % des cas. Il s’agissait d’une transsection de type I (11 cas), de type II (27 cas), de type III (19 cas) et de type IV (7 cas). La voie d’abord était vaginale dans 64 cas et associée à une voie haute dans 2 cas. Nous avons enregistré une guérison dans 37 cas, un échec dans 21 cas et une incontinence urinaire dans 6 cas. Les mauvais résultats étaient statistiquement liés au type de transsection (type III et IV), à l’état scléreux du vagin et au nombre de cure antérieure. La FVV à type de transsection est un type de FVV grave secondaire à un travail dystocique prolongé chez des parturientes jeunes. La voie d’abord préférentielle était la voie vaginale. Les difficultés techniques étaient liées aux lésions associées et l’atteinte du système de continence.

Objective: To describe the clinical aspects of varicocele and to evaluate the outcome of its treatment at the Department of Urology and Andrology of Conakry University Hospital, Republic of Guinea.Patients and Methods: This prospective study included 119 patients with varicocele operated on at the Department of Urology and Andrology of Conakry University Hospital over a one-year period. Clinically, the varicoceles were classified into four grades according to the classification of Dubin and Amelar. All patients received at least one semen analysis pre- and postoperatively.Results: The mean age of the patients was 38 (range 22-53) years. In 80.7% (n = 96) of the cases the varicocele was detected in the course of an infertility consultation. The varicocele was located on the left side in 84.9% (n = 101) of the cases, while it was bilateral in 15.1% (n = 18). Preoperative semen analysis was normal in 5% of the cases. Oligo-astheno-teratozoospermia seen in 46.2% (n = 55) of the patients was the most frequently found anomaly. All patients underwent surgical treatment using the Ivanissevich procedure. After a mean follow up of 17 months conducted on 113 patients, significant improvement in sperm quality was observed in 67 patients with normalization of the sperm count in 33 of them. However, no improvement was noted in 6 out of 8 patients who had presented with azoospermia. Forty-two (35.3%) spontaneous pregnancies were recorded during the follow-up period.Conclusion: Varicocele is a common condition in our daily practice. It is most commonly detected in the course of consultation for infertility. The spermatic profile is that of oligo-astheno-teratozoospermia. Surgical treatment significantly improves the hypofertile patient's fertility. (C) 2015 Pan African Urological Surgeons' Association. Production and hosting by Elsevier B.V. All rights reserved.