Therapeutic Itinerary of Women with Uterine Fibroids in Abidjan: About 170 Cases at the Cocody University Hospital (UH-C)

Summary Introduction: The uterine fibroid is responsible for serious complications in African black women and represents the leading cause for hysterectomy. Material and method: We did a prospective descriptive casecontrol study over 3 years, from October 1, 2012 to September 30, 2015. The study was carried out with the help of 170 patients with uterine fibroid operable whom 129 had an itinerary of alternative care, called case group; and 41 who only visited the hospital which constituted the control group. We performed surgery for 82 patients in the case group and 41 patients in the control group and then compared the two groups including management and prognosis. Results: In the case group, patients had an age between 30 and 40 years in 45.2% and were zero gravidity in 39.2%; against 63.4% and 19.5% respectively in the control group; with a statistically significant difference (alpha=5%). The reasons for consultation of the patients in the case group were genital hemorrhage in 75.6%; pelvic pain in 29.3% or pelvic mass in 49.9%. While in the control group, these same reasons of consultation were accounted respectively for 70.7%; 7.3% and 21.2% with a statistically significant difference. Most of the patients consulted in first intention a traditional healer (43.9%) and saw their worst condition (RR=4,5). A hysterectomy was performed in 22% among cases compared to 7.3% in the controls. Discussion: The trend of the first consultations made to the traditional healers. The condition worsens with the appearance of a larger number of pelvic mass and pelvic pains. There is more realized hysterectomy among cases than controls. Conclusion: Patients have unconventional therapeutic itinerary which expose them to a hysterectomy.