The etiology of major, acquired female urogenital and rectovaginal lesions in Port Harcourt, Nigeria

Monday Komene Sapira 1, * and Emmeh Sweiyi Fiddo 2

1 Department of Surgery (Urology Division), University of Port Harcourt Teaching   Hospital, Port Harcourt, Nigeria.
2 Department of Obstetrics and Gynecology, University Teaching Hospital, Port Harcourt, Nigeria.
 
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2023, 14(02), 037–045.
Article DOI: 10.30574/wjbphs.2023.14.2.0202
Publication history: 
Received on 12 March 2023; revised on 01 May 2023; accepted on 03 May 2023
 
Abstract: 
Introduction: New and emerging trends in the causation of urogenital and rectovaginal lesions, and changing patterns of behavior of female patients with the diseases were observed. The aim of this study is to determine the risk factors and etiology of these diseases.
Methods: This was a cross-sectional observational study of records of consecutive female patients operated on at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria, with major urogenital and rectovaginal lesions from 01/01/2018 to 31/12/2022.  Each patient’s records, sociodemographic data, clinical assessment, laboratory investigations, diagnosis, and intraoperative findings were studied and recorded. Data obtained were analyzed with simple statistics, and presented in charts prose, and tables.
Results: Twelve major cases were found and studied. Their age statistics (in years) were as follows: mean age, 38.6±11.5; median, 34; and age range of 25 to 68. Ten of them were within the childbearing age (15-45 years). One patient had a uterocutaneous fistula with subcutaneous endometriosis. Another had anorectal carcinoma with rectovesical and rectouterine fistulas. One had uterovesical fistulas with menouria (Youssef’s syndrome), and the fourth had uterovesical fistula with a perineal tear. Four patients had uterovaginal prolapse, and 4 had vesicovaginal fistulas.  Obstetric and gynecological trauma and sexual battery accounted for nine of 12 cases.  The patients had high-risk pregnancies but had antenatal care and labor managed by either traditional birth attendants or primary healthcare staff at peripheral institutions.  
Conclusion: Most of the risk and etiological factors of the lesions were found modifiable. Appropriate measures have been suggested for the management and prevention of the lesions.
 
Keywords: 
Urogenital and rectovaginal lesions; Acquired and major; Etiology in females; Port Harcourt; Nigeria
 
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