Cancer of the penis associated with HIV: a report of three cases presenting at the CHU cocody, ivory coast.

BACKGROUND: We describe three cases of advanced penile cancer associated with HIV infection. CASE PRESENTATION: Advanced penile cancer associated with VIH infection were discovered in three patients aged respectively 47, 56 and 40. The prognosis was extremely poor. Two patients died without receiving any treatment and one patient was lost to follow-up after refusing all treatment proposed. CONCLUSION: There appears to be a link between HIV infection and penile cancer with concomitant HIV infection worsening the prognosis of the disease.

[Evolution aspect of anatomy clinical lesions of urogenital fistula (UGF) in Cocody Teaching Hospital urological unity from 1990 to 2011]. / Aspect évolutif des lésions anatomo-cliniques des fistules urogénitales (FUG) dans le service d'urologie du CHU de Cocody de 1990 à 2011.

PURPOSE: The aim of this study is to compare anatomy pathological lesions seeing in urogenital fistula in Cocody Teaching Hospital between two decades, 1990 to 2000 and 2000 to 2010. MATERIEL AND METHOD: This survey is retrospective and carries on 20 years (January 1990 to December 2011) 190 urogenital fistulas (140 cases between 1990 and 1999; 50 from 2000 to 2011) hospitalized in our unity. Anatomy clinical characteristics of these fistulas were determined by clinical or paraclinical examination. RESULTS: Between 1990 and 1999, fistulas were classified in 20 bladder-uterine fistulas (14.29%), 16 uretro-vaginal fistulas (11.43%) and 104 bladder-vaginal fistulas (74.29%) of whom 80 isolated UGFs and 24 UGFs associated with recto-vaginal fistula. These 104 UGFs were located at: bladder neck 22 cases (21.15%), bladder trigonal 46 cases (44.23%), urethra 14 cases (13.46%). Twenty-two bladder sphincter were destroyed and represented 21.15% of fistula's bladder-vaginal fistula and 15.71% of all UGFs. The average fistula diameter was 3 cm [extremes: 1 and 12 cm]. In 22 cases (15.71%), fistula diameter was more than 10 cm. It was bladder neck and sphincter destruction. Hundred and twenty-six fistulas were isolated (90%). Only 10% (14 cases) were associated. Fistulas were primitive in 85.71% of cases (120/140), recurrent in 7 cases (7.86%) and multi-recurrent (>3 reinterventions) in 9 cases (6.43%). From 2001 to 2011, no bladder-uterine fistulas were seen, but: 6 (13.95%) isolated uretero-vaginal fistulas and 6 (13.95%) uretero-vaginal fistulas associated with bladder-vaginal fistula, 31 (62%) bladder-vaginal fistulas of whom 20 (64.52%) bladder trigonal fistulas, 6 (19.34%) retro-trigonal fistulas and 2 (6.45%) urethral fistulas. Only three (9,68%) recto-vaginal fistulas were associated. The average fistula diameter was 2 cm. The fistulas were isolated in 40 cases (80%) and associated (VVF+uretero vaginal F) in 10 cases (20%). Thirty-five cases (70%) were primitive and 10 cases (20%) recurrent of whom 5 (10%) many recurrent. Fistulas were classified in simple fistula in 7 cases (14%) and complex fistula in 43 cases (86%) CONCLUSION: UGF remained relatively frequent in Cocody Teaching Hospital, but the lesions have favorably evolved in the last decade. Simple type of fistula became more frequent than complex ones. LEVEL OF EVIDENCE: 4.

[Study of urogenital fistulas in the Ivory Coast at the end of the 20th century. Results of 70 cases]. / Le point sur les fistules urogénitales en Côte d'Ivoire à la fin du XXe siècle. Résultats de 70 cas.

The urogenital fistulas (UGF), mostly in Africa and particularly in Ivory Coast, still represent a great flail nowadays. However, the authors notice, through a study of 70 cases done in Ivory Coast over (ten) 10 years, that a relative decrease of the impact of the urogenital fistulas troubles still remains a serious affection of young women who can give birth. They are about 30 years old and more; that is to say primipares (44.28%) but over all multipares (54.28%) and poor ones (100%). Most cases are obstetrical causes which expose those women to genital mutilations (25.71%) linked to birth giving difficulties which also bring about many dead born (14.11%) and divorces (20%).

[Nosocomial urinary stent infection at the urology service of the Cocody University Hospital Center]. / Infection urinaire nosocomiale sur sonde dans le service d'urologie du CHU de Cocody.

One of the most common complication of urinary stent is urinary infection. At the Cocody University, 28 men and 2 females who had a urinary stent were evaluated for urinary infection, bacterial growth, and their sensitivity to antibiotics. In 85.71% of the cases, the bacteriologic analysis was positive for a mean duration of urinary drainage of 32, 62 days (range 03 to 90 days). Bacterial isolates were: 11 cases of Klebsiella spp, 5 cases of Providencia spp; 1 case of Escherichia coli, 1 case of Serratia marcescens. Among these bacteria, 77.78% were resistant to most of the antibiotics. Therefore, stent urinary infection is mostly due to multi resistant bacteria. Treatment needs an adapted antibiotherapy after removal of the causative agent.

[Hazards of lumbar ureteroscopy: apropos of 4 cases of avulsion of the ureter]. / Des dangers de l'urétéroscopie à l'étage lombaire: à propos de 4 cas d'avulsion de l'uretère.

Ureteroscopy is frequently indicated in the treatment of stones of the pelvic ureter. Access to the lumbar ureter is associated with a higher complication rate: wounds, ureteric rupture, haemorrhage, or more serious lesions such as avulsions of the ureter. We present 4 cases of avulsion of the ureter seen in our department, corresponding to 4 men with stones of the lumbar ureter treated by ureteroscopy, 2 of them after failure of in situ extracorporeal lithotripsy (ESWL) and an attempt to "flush" the stone and the other two because ESWL was not available. The ureteric lesion was related to a Dormia catheter in 2 cases and the ureteroscope in 2 cases. The lesion was diagnosed and treated immediately in 2 patients and after a delay in the other 2 cases. Repair consisted of ureteric reimplantation on a Boari flap (1 case), implantation onto a psoas bladder (1 case), ureteroileoplasty (1 case) and autologous transplantation (1 case). Ureteric lesions prevented uretero-ureterostomy. Ureteric reimplantation on psoas bladder and/or Boari flap appears to be the simplest method, but it cannot always be performed. In the case of avulsion of the ureteropelvic junction with a large defect, autologous transplantation is a method of choice in young subjects. Ureteroileoplasty appears to be reserved for elderly patients.

[Malignant kidney tumors in adults in Senegal: diagnostic and therapeutic problems]. / Les tumeurs malignes du rein de l'adulte au Sénégal: problèmes diagnostiques et thérapeutiques.

The aim of this study was to analyze problems posed by adult renal malignant tumors both in the diagnostical and therapeutical viewpoints. We have performed a retrospective study including 48 cases of confirmed renal cancer. Have been included adult patients who presented a cancer of the kidney operated or not. Studied parameters were age, sex, clinical signs, complementary explorations i.e. biology, renal ultrasonography, IVU, Computerized tomography, the operative indication and the prognosis. We have used Robson's staging to classify our patients. The average age was 51 years with extremes of 18 and 83 years. However 60% of them were less than 50 years. Adenocarcinoma was the main histological form encountered. It has been found in 93% of cases. The flank mass has been the mode of discovery in 70.8% of cases. The classic symptomatic triad associating hematuria, pain and the renal mass has been found in 20.8% of cases. Ultrasonography and Intravenous urography (IVU) have allowed to pose the diagnosis in 93.75% of cases. Patients were often referred very late with an average delay of consultation of 14 month. So, 25% of them presented with metastasis at the moment of the diagnosis. Radical nephrectomy was performed in 60% of cases. 40% of patients have not been operated due to the advanced evolution of the tumor. The global mortality to 1 year was estimated at 38%. We conclude that renal malignant tumors in the adulthood, in our practice, presents some particularities. Indeed, patients are referred late when clinical symptoms are sufficiently evocative to suspect the diagnosis. At these advanced stages, there is no curative therapeutic. So, a precocious diagnosis is necessary in order to propose to patients radical nephrectomy which remains the only efficient therapeutical procedure of the localized renal cancer in the adulthood.

[Peyronie's disease and peripheral neuropathies]. / Maladie de Lapeyronie et neuropathies périphériques.

The association between Peyronie's disease and diabetes mellitus or Dupuytren's disease is well described in the literature with a certain frequency. Through our 10 patients with Peyronie's disease, when have noticed that only one of them is undergoing diabetes mellitus and no one has Dupuytren's disease. But 7 of them presented clinical and/or electromyographical signs of peripheral neuropathy. So after clinical examination in neurology and urology, we performed measurement of motor conduction velocity of tibial posterior nerves and peroneal nerves, then, we measured sensitive vetocity of sural nerves and dorsal nerve of the penis and we studied the cortical somesthesic evoked potential of the internal hontous nerve and the sympathetic evoked response of the skin. So we hypothesize that peripheral neuropathy with or without autonomic disorders might be an etiological co-factor of Peyronie's disease.

[Giant lithiasic diverticulum of the urethra. Apropos of a case]. / Diverticule géant lithiasique de l'urètre. A propos d'un cas.

In the following observation, the authors report one case of lithiasegenic diverticulum. Etiologies (congenital or acquired), complications and principal radiological diagnosis methods are reviewed.