Progressive Urological Complications of Advanced Gynecological Cancers in Guinea: Epidemiological, Clinical and Therapeutic Aspects

<i>Introduction:</i> Progressive urological complications represent a urological emergency and an unfavorable prognostic factor in advanced gynecological cancers. This study aimed to describe the epidemiological, clinical, therapeutic, and evolutionary aspects of these complications at the Ignace Deen University Hospital in Conakry. <i>Methodology:</i> Prospective cross-sectional descriptive study conducted in the urology department of Ignace Deen University Hospital over 2 years (January 2024-December 2025). This study included patients with gynecological cancer presenting progressive urological complications. Variables studied were demographic (age, parity), clinical (histological type, FIGO stage, ECOG performance status), paraclinical (serum creatinine, hemoglobin, ultrasound), therapeutic (urinary drainage, oncological treatments), and evolutionary. Upper urinary tract drainage was performed by percutaneous nephrostomy or JJ stent placement. <i>Results:</i> We recorded 88 patients who presented with gynecological cancer with progressive urological complications. The mean age of patients was 54.3±11.5 years. Cervical cancer represented 96.6% (squamous cell carcinomas), predominantly at stage IIIB (61.2%). The general condition of patients was severely deteriorated: 59.1% ECOG III and 40.9% ECOG IV. Isolated bilateral ureterohydronephrosis constituted the main complication (47.7%). JJ stent drainage was successful in 55.7% of patients, percutaneous nephrostomy in 22.7%, with a failure rate of 21.6%. Mean serum creatinine decreased from 10.1 to 6.5 mg/dl (36% reduction), hemoglobin increased from 6.9 to 10.0 g/dl. Exclusive palliative care was provided to 73.9% of patients, 21.6% received chemotherapy. Mean hospital stay was 6.2 days with in-hospital mortality of 11.4%. <i>Conclusion:</i> This study reveals that urological complications of gynecological cancers in Guinea are characterized by late diagnosis and limited therapeutic options. Despite the feasibility of urinary drainage, the massive recourse to palliative care underscores the poor prognosis. Priorities include HPV vaccination, early screening, strengthening of technical facilities, and development of appropriate palliative care structures.