RESUMEN
OBJECTIVES: The objective of this study was to evaluate the sexuality of SS sickle cell patients with a history of priapism. METHODS: This was a case-control study of adult SS sickle cell patients. The occurrence of priapism as well as the nature of the priapism had been investigated. The patients were subdivided into three groups: Group 1 (no priapism), Group 2 (intermittent priapism) and Group 3 (acute priapism). The patients' sexuality was studied using the IIEF-15 questionnaire. RESULTS: We interviewed 191 SS sickle cell patients. The mean age was 27.1±7.1 years. Priapism was observed in 43.5 %. Only 77 patients were eligible for the IIEF15 questionnaire. Groups 1 and 2 performed significantly better than group 3 on erectile function (EF) and orgasmic function (OF) scores. There was no significant difference in the EF and OF scores between groups 1 and 2. No significant difference was observed between the three groups for the scores of sexual desire (SD), intercourse satisfaction (IS), and overall satisfaction (OS). The impairment of erectile function in group 2 was related to the age of the first episode of priapism and the last episode. The impairment of erectile function in group 3 was related to the duration of evolution (P<0.05). CONCLUSION: This study shows that priapism is responsible for impaired erectile function in SS adult sickle cell patients. A program to prevent intermittent episodes of priapism should be put in place.
Asunto(s)
Anemia de Células Falciformes , Disfunción Eréctil , Priapismo , Adulto , Anemia de Células Falciformes/complicaciones , Anemia de Células Falciformes/epidemiología , Estudios de Casos y Controles , Disfunción Eréctil/epidemiología , Humanos , Masculino , Priapismo/etiología , Senegal , Sexualidad , Adulto JovenRESUMEN
OBJECTIVE: To report our experience with anastomotic uretroplasty (AU) due to male urethral stricture disease (USD) and to identify factors affecting the results. PATIENTS AND METHODS: We conducted a retrospective study over a period of 4 years and 6 months (July 2012 to December 2016). Any subsequent use of endoscopic urethrotomy or new urethroplasty was considered a failure. RESULTS: Forty-eight cases were included. The mean age of patients was 53.5±17.3 years (23-87 years). Urinary retention was the reason for consultation in 42 cases (87.5%). The most common localization of USD was the bulbar urethra (n=45). The mean length of USD was 1.23±0.62cm (0.5-3cm) with a median length of 1cm. The etiology was post-infectious in 56.3% of cases. More than half (58.3%) of patients had already undergone at least one urethral manipulation. After an average follow-up of 21.1±12.6 months (1 to 52 months), the overall success rate was 77.1%. In univariate analysis, length, cause and location of the stricture, age of patient, the presenting symptoms of the stricture, previous urethral manipulation and surgeon experience did not significantly impact on the success rate of anastomotic urethroplasty at one and two years follow-up. CONCLUSION: The AU had provided good results in our practice. The infectious origin of the stricture and previous urethral manipulation did not significantly impact the result of this surgical technique. LEVEL OF EVIDENCE: 4.
Asunto(s)
Anastomosis Quirúrgica/métodos , Estrechez Uretral/cirugía , Procedimientos Quirúrgicos Urológicos Masculinos/métodos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Procedimientos de Cirugía Plástica/métodos , Estudios Retrospectivos , Resultado del Tratamiento , Estrechez Uretral/etiología , Estrechez Uretral/patología , Adulto JovenRESUMEN
Scrotal calcinosis is a rare pathology and etiology still discussed. We report five cases in patients without particular history of another disease. Clinical examination revealed scrotal wall with painless nodules of various sizes producing a whitish substance, pasty. The phosphate levels were normal in all patients. They all had a resection of the lesions associated with scholarships plasty recovery. Histopathological study revealed calcified epidermoid cysts in 4 cases.
Asunto(s)
Calcinosis/etiología , Quiste Epidérmico/patología , Enfermedades de los Genitales Masculinos/patología , Escroto/patología , Procedimientos Quirúrgicos Urológicos Masculinos , Adulto , Calcinosis/cirugía , Quiste Epidérmico/complicaciones , Quiste Epidérmico/cirugía , Enfermedades de los Genitales Masculinos/etiología , Enfermedades de los Genitales Masculinos/cirugía , Humanos , Masculino , Persona de Mediana Edad , Escroto/cirugía , Resultado del Tratamiento , Procedimientos Quirúrgicos Urológicos Masculinos/métodosRESUMEN
PURPOSE: To describe the epidemiological, anatomico-clinical and therapeutic aspects of the patent vaginoperitoneal canal (PVPC) in urological practice and to compare our results with those of pediatric teams. PATIENTS AND METHODS: We performed a retrospective descriptive study of PVPC cases operated in a urology unit. The following parameters were studied: medical history, age, method of installation, the anatomo-clinical type, side and the results of the treatment. RESULTS: A total of 163 cases were collected over a period of 5 years. The average age was 7.5 ± 7 years with a range of 2 months and 39 years. Thirty-four patients had less than or equal to age 2 ears and 28 patients were adults. The reason for consultation was an inguinal or scrotal inguinal, painless and intermittent swelling in 72.3% of cases. Installation mode was progressive in 45 patients (27.6%). The PVPC was sitting right in 81 patients (49.7%) and was bilateral in 12 patients (7.3%). The anatomo-clinical types were dominated by the communicating hydrocele (52%). The treatment was carried out in controlled surgery in all patients and the mean duration of hospitalization was 24 hours. The postoperative course was marked by 5 cases of scrotal hematoma and 2 cases of parietal suppuration. Postoperative mortality was zero. After a mean postoperative decrease of 2 years we observed 3 cases of testicular atrophy and two recurrences. CONCLUSION: Our results in terms of morbidity and mortality although satisfactory were lower than those of pediatric teams. LEVEL OF EVIDENCE: 5.
Asunto(s)
Quistes/congénito , Quistes/cirugía , Hernia Inguinal/congénito , Hernia Inguinal/cirugía , Peritoneo/anomalías , Peritoneo/cirugía , Cordón Espermático , Hidrocele Testicular/congénito , Hidrocele Testicular/cirugía , Adolescente , Niño , Preescolar , Enfermedades de los Genitales Masculinos/complicaciones , Enfermedades de los Genitales Masculinos/cirugía , Humanos , Lactante , Masculino , Estudios Retrospectivos , Procedimientos Quirúrgicos Urológicos Masculinos/métodos , Adulto JovenRESUMEN
Bilharzioma are inflammatory pseudotumors, which often pose the problem of differential diagnosis with neoplastic processes. Using the keywords "testicular" and "schistosomiasis", there are only 14 cases of testicular bilharzioma identified on PubMed. The authors report two new cases in a 6-year-old child and an adult of 38 years, collected over a period of 5 years. In both cases, orchidectomy was performed and histological analysis of the surgical specimen was allowed to diagnose testicular bilharzioma by Schistosomia haematobium. The authors emphasize the need to evoke a bilharzioma before any testicular nodule in a patient living in an endemic area.
Asunto(s)
Esquistosomiasis Urinaria , Enfermedades Testiculares/parasitología , Adulto , Niño , Humanos , Masculino , Esquistosomiasis Urinaria/diagnóstico , Esquistosomiasis Urinaria/cirugía , Enfermedades Testiculares/diagnóstico , Enfermedades Testiculares/cirugíaRESUMEN
OBJECTIVE: Describe the epidemiology, diagnosis and treatment of vesicovaginal fistula (VVF). PATIENTS AND METHODS: We conducted a retrospective descriptive study of all cases of VVF secondary to hysterectomy. The following parameters were studied: age, parity, indication for hysterectomy, risk factors, the consultation period, the anatomical type of VVF, the paraclinical, the surgical approach and results of the cure. RESULTS: Fourteen cases were identified over 10 years. All hysterectomies were performed by laparotomia. The average age of patients was 54.3±13 years. Hysterectomy was performed in view of a uterine leiomyoma in eight cases, a cancer of the cervix in four cases, a menometrorrhagia in one case and a choriocarcinoma in one case. Four patients had received neoadjuvant radiotherapy. The mean time from injury was 13.5±18 months. Examination under valve was allowed to find 11 VVF type 1 and three type 2 VVF. IVU was normal in seven patients and allowed to find an ureterohydronephrose stage III in one patient. VVF was addressed by high in ten cases including 5 by transperitoneovaginale and 5 by transvesical pure. The postoperative course was uneventful in 11 patients (78%) but marked by vesicocutaneous fistula, parietal suppuration and one failure. CONCLUSION: In this short series of post-hysterectomy VVF treated by laparotomia, we observed a rate of cure satisfying in spite of an important psychosocial morbidity.
Asunto(s)
Histerectomía/efectos adversos , Fístula Vesicovaginal/etiología , Adulto , Anciano , Coriocarcinoma/terapia , Femenino , Humanos , Leiomioma/cirugía , Persona de Mediana Edad , Paridad , Radioterapia Adyuvante/estadística & datos numéricos , Estudios Retrospectivos , Factores de Riesgo , Tiempo de Tratamiento , Neoplasias del Cuello Uterino/terapia , Neoplasias Uterinas/cirugía , Fístula Vesicovaginal/cirugíaRESUMEN
OBJECTIVES: To evaluate the results of Anderson-Hynes open pyeloplasty in our institution. And then to compare them to those of laparoscopic procedure and identify what can be considered now as the indications of the open procedure. PATIENTS AND METHODS: It was a retrospective study on 30 cases of ureteropelvic junction syndrome managed by Anderson-Hynes open procedure. The clinical, biological and radiologic characteristics of the patients as well as the surgical technique and its results were taken into account. The patients were classified, according to Valdeyer and Cendron classification as type II in eight cases (26.7%), type III in ten cases (33.3%) and type IV in four cases (13.3%). There were also eight cases of giant hydronephrosis (26.7%). The operating time, the length of hospital stay and the outcomes were studied and compared with those of the laparoscopic pyeloplasty found in the medical literature. RESULTS: The mean operating time was 115 ± 33.4 minutes (90-230 min). The mean length of hospital stay was 10.4 ± 5.1 days. Six patients (20%) had postoperative complications. After a mean follow-up of 28 ± 13.7 months (13-48 months), our first-hand success rate was 90% (n=27). CONCLUSION: Anderson-Hynes open pyeloplasty reached good results but nowadays its indications can be limited to laparoscopic contraindications, severe hydronephrosis (grade IV or giant hydronephrosis) and second-hand cases. The two latter indications depend on the surgeon experience in laparoscopic surgery.
Asunto(s)
Hidronefrosis/cirugía , Pelvis Renal/cirugía , Laparoscopía , Obstrucción Ureteral/cirugía , Procedimientos Quirúrgicos Urológicos/métodos , Adolescente , Adulto , Niño , Preescolar , Dilatación Patológica , Femenino , Estudios de Seguimiento , Humanos , Hidronefrosis/diagnóstico , Pelvis Renal/patología , Laparoscopía/métodos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Síndrome , Factores de Tiempo , Resultado del TratamientoRESUMEN
PURPOSE: To report epidemiological, clinical and paraclinical features of pyonephrosis and describe current management methods in Senegal. PATIENTS AND METHODS: This retrospective study includes a series of patients admitted for pyonephrosis to the Urology Department of the Aristide Le Dantec Hospital in Dakar between 1995 and 2009. The following information was collected for each patient: age, sex, clinical manifestations, diagnostic findings, treatment modalities and outcomes. RESULTS: A total of 44 patients with a mean age of 34 years were included. The most common clinical manifestations were acute flank pain, sepsis and renal mass. Diagnostic was usually based on medical imaging, i.e., renal utrasonography and computed tomography. Urolithiasis was the underlying etiology in 73.2% of cases. Nephrectomy was performed in 83% of cases with or without preliminary nephrostomy catheterization. CONCLUSION: Development of both diagnostic (medical imaging) and therapeutic methods for management of pyonephrosis has been consistent with the rarity of this condtion in Senegal.
Asunto(s)
Pionefrosis/diagnóstico , Pionefrosis/terapia , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Niño , Preescolar , Diagnóstico por Imagen , Femenino , Dolor en el Flanco/etiología , Humanos , Masculino , Persona de Mediana Edad , Nefrectomía/estadística & datos numéricos , Pionefrosis/etiología , Estudios Retrospectivos , Senegal/epidemiología , Sepsis/etiología , Urolitiasis/complicaciones , Adulto JovenRESUMEN
OBJECTIVE: To study current epidemiological and clinical features of adult renal cancer in Senegal and the evolution of these features over the two past decades. PATIENTS AND METHODS: We conducted a retrospective ten years study (2000-2009) that analyzed all the renal cell cancer in adult admitted in the urology department and the pathology department of the university teaching hospital Aristide-Le-Dantec (Dakar). The results of this study were compared with those of the previous decade. RESULTS: We included 74 cases of renal cell cancer. The median age of patients was 49 years (18-72 years). There was a slight female predominance (51.3%). Twenty-eight (37.8%) patients presented at least with one renal cell cancer risk factor. The median duration of symptoms was 10 months (1-96 months). The localization of the renal cancer was right in 42 patients (56.7%) and left in 32 cases (43.8%). Almost all the tumors were symptomatic. Symptoms were dominated by loin pain (87.8%) and abdominal mass (77%). There were only two cases (2.7%) of incidental renal cell cancer. The median tumor size was 12 cm (2.4-26 cm). The more frequent tumor stages according to the TNM 2002 staging system were T2 (39.2%) and T3 (33.7%). Metastases were found in 23 (31%) patients. Forty-four patients underwent nephrectomy (43 radical and one partial). No adjuvant treatment or metastasectomy were done. The main histological subtype of tumors was renal cell carcinoma (47 cases). The mean duration of the follow up was 30.5 ± 33.6 months. Among the 44 patients who underwent nephrectomy, no tumor recurrence was found on 35 cases. Tumor recurrence occurred on nine patients. The specific mortality rate was 47.3%. Epidemiological and clinical features of the adult renal cell cancer in Senegal haven't significantly changed over the 20 past years. CONCLUSION: The adult renal cell cancer incidence was low in Senegal. Its clinical profile was characterized by a predominance of locally advanced and metastatic forms.
Asunto(s)
Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/epidemiología , Neoplasias Renales/diagnóstico , Neoplasias Renales/epidemiología , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Senegal/epidemiología , Factores de Tiempo , Adulto JovenRESUMEN
AIMS: To investigate the antimicrobial spectrum of Lactococcus piscium CNCM I-4031 and its protective effect in cooked and peeled shrimp against Brochothrix thermosphacta. METHODS AND RESULTS: Sixteen pathogenic and spoiling bacteria were inhibited in Elliker, but not in shrimp juice agar plates. In shrimp packed under modified atmosphere and stored at 8 degrees C, B. thermosphacta (10(3) CFU g(-1)) was inhibited by 4.1 log CFU g(-1) when co-inoculated with L. piscium (10(6) CFU g(-1)). Brochothrix thermosphacta spoiled the product after 11 days, with the emission of strong butter/caramel off-odours. In co-culture with L. piscium, sensory shelf-life was extended by at least 10 days. The inhibition was partially explained by a drop in pH from 6.6 to 5.6. The physicochemical composition of shrimp and shrimp juice was established to identify the inhibition mechanisms involved. CONCLUSION: Lactococcus piscium CNCM I-4031 has a wide antimicrobial spectrum. The strain inhibits B. thermosphacta in shrimp and significantly prolongs sensory shelf-life. SIGNIFICANCE AND IMPACT OF THE STUDY: Lactococcus piscium CNCM I-4031 is shown to be a promising agent for improving shrimp quality and may be tested against pathogens and in other food matrices. Knowledge of the physicochemical composition of shrimp and shrimp juice will allow the development of a chemically defined model medium for determining the inhibition mechanisms involved.
Asunto(s)
Bacterias/crecimiento & desarrollo , Contaminación de Alimentos/prevención & control , Microbiología de Alimentos , Lactococcus/crecimiento & desarrollo , Mariscos/microbiología , Antibiosis , Técnicas de Cocultivo , Medios de Cultivo , Manipulación de Alimentos , Mariscos/análisisRESUMEN
UNLABELLED: To describe clinical and therapeutic features of ischemic priapism associated with sickle cell disease (SSD) in Senegalese men and to identify risk factors for erectile dysfunction (ED). PATIENTS AND METHODS: The charts of all patients admitted to the Urology Department of Aristide Le Dantec University Teaching Hospital (Dakar) for ischemic priapism associated with SSD between January 2000 and September 2008 were retrospectively reviewed. RESULTS: A total of 22 patients with a mean age of 19.5 +/- 9.9 years (6 - 41 years) were identified. The most affected age group was between 21 and 30 years. The mean duration between onset of the episode and admission was 89.6 +/- 103.1 hours (4 - 384 hours). Nine patients (40.9%) were admitted within 24 hours after the onset. Eight patients (36.3%) had a history of stuttering priapism. The sickle cell phenotype identified by electrophoresis was SS in 18 patients and AS in four. The main treatment modalities were corporeal aspiration that was performed with or without intracavernosal injection of sympathomimetics drugs and Al Ghorab shunt surgery that was used in ten patients with a success rate of 90 % (complete detumescence). With a mean follow-up of 3.8 +/- 1.5 years, nine (69.2%) of the 13 patients older than 16 years developed ED. The incidence of ED was significantly correlated with the duration of the priapism but not with SSD phenotype. CONCLUSION: In Senegal ischemic priapism associated with sickle cell disease occurs mainly in young people. The incidence of ischemic priapism appears to be low but ED is common due to the prolonged duration of priapism.
Asunto(s)
Anemia de Células Falciformes/complicaciones , Disfunción Eréctil/etiología , Priapismo/etiología , Enfermedad Aguda , Adolescente , Adulto , Niño , Estudios de Seguimiento , Humanos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Senegal , Adulto JovenRESUMEN
PURPOSE: To report the oncologic results and morbidity of bilateral pulpectomy and to identify factors that make this method of androgen suppression therapy the most used in our country. PATIENTS AND METHODS: We conducted a prospective study in the urology department of Aristide Le-Dantec hospital (Dakar) between January 2008 and June 2010 (30 months). It included 84 cases of prostate cancer treated by bilateral pulpectomy under local anesthesia. RESULTS: The mean age of patients was 72.17±12.48 years (53-91). The median PSA level was 101 ng/mL (12.18-9990). Metastasis have been detected in 75% of cases. The Gleason score was higher than 7 in 40 patients (47.6%). Three months after pulpectomy, an improvement of performance status was seen in 76 patients (90.4%). The back pain significantly decreased in intensity or disappeared in 65.3% (32/49) of cases. A complete recovery of lower limbs motor deficit was observed in 50% of cases (7/14). The PSA levels decreased in 57 of the 76 patients alive and the mean PSA level was then 72±11.7 ng/mL (3.8-2433). At six months, of the 53 patients in urinary retention, 18 had recovered spontaneous and complete urination. The PSA level was below 4 ng/mL in 33.8% (22/65) of cases and between 4 and 10 ng/mL in 52.3% (34/65) of cases. At 12 months, the median PSA nadir was 0.76 ng/mL (0,002-8,17) and 57.4% of the 54 patients alive had a PSA nadir less than 2 ng/mL. The mean follow-up was 11.08±10.34 months (1-30). A rising PSA occurred in 17 patients (20.2%) after an mean progression-free survival of 10.5 months (6-25). The overall survival at 6, 12 and 24 months were respectively 77.3, 64.3 and 52.3%. The overall cost of pulpectomy was 50 000 FCFA (76). The specific morbidity of pulpectomy was two cases (2.4%) of infection of the operative site. CONCLUSION: The bilateral pulpectomy was a method of androgen suppression immediately effective, efficacious with a low morbidity. Its very low cost is the main reason why it is still the most used method in our country.
Asunto(s)
Orquiectomía/métodos , Neoplasias de la Próstata/cirugía , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
OBJECTIVE: To assess the feasibility of selective clamping of segmental renal arteries during partial nephrectomy, in order to limit renal infarction to the pathological area to be resected. MATERIALS AND METHODS: A dissection of renal artery and its extraparenchymal branches was realised. The study included 30 kidneys from recent nonformolised corpses. The size, distribution, and accessibility of the arteries were considered. All the corpses underwent a lombotomy with or without rib resection. RESULTS: The majority of dissected kidneys had a unique artery (96.66% of cases). The number of segmental arteries was zero in five cases (16.66%), one in four cases (13.33%), two in four cases (13.33%), three in one case (3%), four in 15 cases (50%) and five in five cases (16.66%). The posterior and inferior segmental arteries were more accessible to isolate with a respective ratio of 94 and 100% at segmental level. Apical and middle segmental arteries were least accessible with a respective ratio of 73 and 80%. The majority of accidents during dissection occurred with the middle segmental artery (62.5% of vascular lesions). CONCLUSION: This anatomic dissection on corpses showed that selective renal segmental arteries is possible in the majority of cases. This dissection is better indicated in partial nephrectomies for renal tumours located posteriorly or in the lower pole.
Asunto(s)
Nefrectomía/métodos , Arteria Renal , Adulto , Cadáver , Constricción , Estudios de Factibilidad , Femenino , Humanos , MasculinoRESUMEN
Abdominoscrotal hydrocele is a very rare clinical entity especially in childhood with less than 100 paediatric cases reported in the literature. It is associated with various complications and its pathogenesis is still a matter for debate. The authors report a case of abdominoscrotal hydrocele in the child. The methods of the diagnosis as well as the specific treatment are pointed out.
Asunto(s)
Hidronefrosis/complicaciones , Hidrocele Testicular/complicaciones , Hidrocele Testicular/cirugía , Enfermedades Ureterales/complicaciones , Niño , Humanos , Hidronefrosis/diagnóstico , Masculino , Hidrocele Testicular/diagnóstico por imagen , Ultrasonografía , Enfermedades Ureterales/diagnósticoRESUMEN
Vulvar localisation of schistosomiasis is a rare presentation. We report a case of a woman of 20 years old hospitalised for a vulvar mass of six months. That mass progressively increased in volume and was tender. It was accompanied by frequency and dysuria. The patient had a history of swimming in fresh water and hematuria when she was eight years old. Initial clinical examination found a good general state, there was a mass involving the clitoris and the small lips. This painless mass had a cauliflower appearance and was soft with a large implantation. Pathology exam of the mass revealed a vulvar schistosomiasis with an important amount of living eggs. A tumour removal with a plasty of small lips was performed. Additionally, praziquantel was administered orally. Vulvar localisation of schistosomiasis might suggest a malignant tumour. Only pathological examination can assess the diagnosis.
Asunto(s)
Esquistosomiasis/diagnóstico , Enfermedades de la Vulva/parasitología , Adulto , Animales , Femenino , Agua Dulce , Humanos , NataciónRESUMEN
OBJECTIVE: To present the epidemiological, clinical and histological profile of the bladder cancer in Senegal. MATERIAL AND METHOD: The authors conducted a retrospective study based on registries and clinical data of patients admitted for bladder cancer confirmed by the histology at the university hospital Aristide-Le-Dantec of Dakar. RESULTS: Four hundred and twenty-eight bladder cancers were recorded. The incidence of the bladder cancer was 2.5% of the whole of cancers. The mean age of the patients was 45.5 years (range 12-86 years). The sex-ratio was 1.25. The majority of the patients consulted for low urinary tract symptoms (94.5%) and hematuria (88%). The prevalent histological type was squamous cell carcinoma (50.70%). CONCLUSION: The bladder cancer in Senegal is a cancer of the young adult. The prevalent histological type is squamous cell carcinoma.
Asunto(s)
Carcinoma de Células Escamosas , Carcinoma de Células Transicionales , Neoplasias de la Vejiga Urinaria , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/patología , Carcinoma de Células Transicionales/diagnóstico , Carcinoma de Células Transicionales/epidemiología , Carcinoma de Células Transicionales/patología , Niño , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Senegal/epidemiología , Factores Sexuales , Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/epidemiología , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
UNLABELLED: Prune Belly syndrome (PBS) is a rare complex malformation with male predominance. His pathogeny is not yet completely elucidated. The goal of this work is to analyze the epidemiological, anatomoclinical and treatment aspects of a retrospective trial in Aristide-Le-Dantec Hospital. PATIENTS AND METHODS: We carried out a retrospective study about 22 cases collected in the departments of urology-andrology and pediatric surgery in Aristide-Le-Dantec Hospital between April 1995 and November 2004. RESULTS: The mean age of the patients was 15 months with extremes of one day and 10 years. The somatic examination revealed 20 cases of complete abdominal muscle aplasia, one right partial form and the last case had a left partial form. Nineteen patients were managed with conservative treatment and three patients benefited a surgical act for urinary abnormalities. The Montfort intervention was performed in two patients respectively aged eight and 10 years. The orchidopexy, stage 1, by Fowler-Stephens technique was performed in 13 cases. Five cases of death and nine cases of testicular atrophy after orchidopexy occurred. The followings were satisfactory in the three operated patients for urinary abnormalities. CONCLUSION: The renal failure is the main cause of death. The management of the urinary tract abnormalities must be performed individually. The testis descending should be performed in newborn period to enhance the fertility chances. The abdominoplasty also should be done early for aesthetic reason and to improve pulmonary, defecation, and voiding functions.
Asunto(s)
Síndrome del Abdomen en Ciruela Pasa , Niño , Preescolar , Criptorquidismo/cirugía , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Masculino , Nefrostomía Percutánea , Síndrome del Abdomen en Ciruela Pasa/complicaciones , Síndrome del Abdomen en Ciruela Pasa/diagnóstico , Síndrome del Abdomen en Ciruela Pasa/diagnóstico por imagen , Síndrome del Abdomen en Ciruela Pasa/epidemiología , Síndrome del Abdomen en Ciruela Pasa/cirugía , Insuficiencia Renal/diagnóstico por imagen , Insuficiencia Renal/etiología , Estudios Retrospectivos , Factores de Tiempo , Ultrasonografía , UrografíaRESUMEN
OBJECTIVE: To present the epidemiological, clinical and therapeutic features of the urological emergencies in Senegal, West Africa. MATERIAL AND METHODS: The authors conducted a 20 months retrospective study that analyzed the epidemiological, clinical and therapeutic features of all urological emergencies admitted to the urology department of the university teaching hospital Aristide-Le-Dantec (Dakar). RESULTS: There were 1237 urological emergencies. The mean age of the patients was 58.8 years (range one month-94 years). The sex ratio (M/F) was 20.32. These patients had an age equal to or higher than 60 years in 50.7% of the cases. The most frequent illness was urinary retention (53%) and genitor-urinary system infectious, which represented as a whole 16.4% of the cases. The gangrenes of male external genitalia (Fournier's gangrene) accounted for 4.1% of the cases and the priapism 1.3%. In emergency, 331 surgical operations were performed. The most performed procedures were the installation of a suprapubic catheter (59.8%) and debridement of a gangrene of male external genitalia (15.4%). CONCLUSION: The most frequent urological emergency in our country was the acute urinary retention. Some serious illness like gangrene of male external genitalia (Fournier's gangrene) and priapism are not rare there.
Asunto(s)
Enfermedades Urológicas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Urgencias Médicas , Femenino , Hospitales Universitarios , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Senegal , Enfermedades Urológicas/diagnóstico , Enfermedades Urológicas/epidemiología , Enfermedades Urológicas/terapia , Adulto JovenRESUMEN
AIM: To dress biologic and histopathologic aspects of the prostatic cancer in urologic hospital center about a set of digital transrectal guided biopsies. METHODOLOGY: It is a prospective study realized between January 2002 and March 2002 (26 months) studying patients with positive prostatic biopsy. RESULTS: Seventy two cases of prostatic cancer were noticed. Mean age of these patients was 69,9 years (54-91 years). Mean rate Total PSA was 134,8 ng/ml (6-2500 ng/ml). Repartition according Gleason score has revealed that only 35% of tumors were well differentiated. The study of correlation between Total PSA rate and Gleason grade has revealed that up to 10 ng/ml Total PSA rate, only 33% of patients had a Gleason grade between 2 and 4 (well differentiated tumor). CONCLUSION: Actual biologic and histopathologic profile of prostatic cancer lays emphasis on later management.
Asunto(s)
Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/patología , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , SenegalRESUMEN
INTRODUCTION: The goal of this study is to access the surgical management of the prostate cancer. PATIENTS AND METHODS: It was a retrospective study including 96 cases of prostate cancer between June 2002 and December 2004. Parameters studied for every patient was: age, the complaints, results of rectal digital examination, the initial TPSA rate, gleason score, results of extension, the clinical grade according to TNM 2002 classification, the treatment and the future of treated patients. RESULTS: The mean age of our patients was 70.9 years with extremes of 50 years and 93 years. The complaints at presentation were dominated by prostatism (43.5%) and urine retention (37.7%). At rectal digital examination, the prostate was suspicious of cancer in 42.7%. The majority of our patients (79.8%) had a TPSA rate superior to 20 ng/ml. The examination revealed that the tumour was an adenocarcinoma in all patients. The majority of our patients (50.3%) had a gleason score inferior to 7. The extension outcome revealed: a loco-regional extension in 63 patients, dorso-lombar bone metastases in 19 patients and absence of secondary localisation in 14 patients. The repartition of patients according TNM classification was as following: T1 (1%), T2 (14.6%), T3 (18.8%) and T4 (65.6%). The patients were managed as following: bladder neck resection (surgically or endoscopically), pulpectomy and radical prostatectomy. CONCLUSION: To ameliorate the prostate cancer management, the highlights of radical prostatectomy is imperative as the spreading of endoscopic surgery in the place of opening surgery.