Analysis, treatment modality and demographic characteristics of urolithiasis patients visiting Korle-Bu Teaching Hospital in Ghana.

Background: Globally urolithiasis is on the rise and gradually becoming a public health concern due to the associated complications. This study reviewed the demographic characteristics, the chemical composition of stones, treatment modality and duration of hospitalisation of urolithiasis patients at Korle-Bu Teaching Hospital, Accra, Ghana. Materials and Methods: This was a retrospective study conducted between March 2019 and April 2022. Data from consecutive patients treated for urolithiasis were used for this study. Data on demographic characteristics, stones chemical composition, urine factors, urolithiasis treatment modality and duration of hospital stay after therapy were collated and analysed using descriptive and inferential approaches. Results: The age of the patients ranged from 2 to 75 years with a mean of 45 (±13.4). The predominant age group for stone formation was 30-39 years - 52(26.3%). Urolithiasis was common among patients in the formal employment sector: 81(40.9%). All stones had two or more chemical compositions, with the combination of calcium oxalate monohydrate, calcium oxalate dihydrate and uric acid being the predominant stone type: 88(57.5%). Ureteroscopy with semi-rigid and Percutaneous nephrolithotomy were the predominant treatment modalities: 105(53.0%) and 74(37.4%), respectively. Escherichia coli was responsible for most urinary tract infections in urolithiasis patients 8(4.0%) and the least duration of hospital stay after the procedure was associated with the use of semi-rigid ureteroscope as the treatment modality with a median duration of 2 days (1-2 days) with P < 0.0001. Conclusions: Urolithiasis was predominant among professionals in the formal sector. All stones were mixed with Calcium oxalate monohydrate, calcium oxalate dihydrate, and uric acid combination being the majority. Ureteroscopy with semi-rigid and percutaneous nephrolithotomy were the common treatment modality.

Penile carcinoma: a report of two cases treated by partial penectomy, its effects on quality of life and review of literature.

Penile cancer is a rare malignancy worldwide except in parts of Africa, Asia and Latin America where higher incidences have been reported. The disease leads to serious physical disfigurement of the male genitalia which can have debilitating consequences, thus it may alter micturition patterns and impair penetrative sexual intercourse. The lack of cancer registries and epidemiological surveillance programs in Ghana makes estimation of the prevalence in Ghana difficult hence to advance the course of knowledge, awareness and prevention of penile cancers, it is imperative that such cases are brought to the fore and discussed. We report two cases of penile cancer that had partial penectomy and inguinal lymphadenectomy at the Korle Bu Teaching Hospital. Clinical findings and intervention of these reported cases highlight the management process and it further assessed the psychological impact of intervention. The two patients presented to our outpatient department with penile lesions which were confirmed to be penile cancer. The first patient presented with a 30 year history with recurrent ulceration while the other presented with just 1 (one) year history of penile lesion. Both patients required partial penectomy and inguinal lymphadenopathy in the treatment of their condition. The major risk factors as reported in this case study, include uncircumcision, previous treatment for sexually transmitted infections, multiple sexual partners and smoking. Treatment is associated with reduction in sexual function although quality of life may remain satisfactory. Strong family and psychological support are key cornerstones for good treatment outcomes.

Prostate brachytherapy in Ghana: our initial experience.

PURPOSE: This study presents the experience of a brachytherapy team in Ghana with a focus on technology transfer and outcome. The team was initially proctored by experienced physicians from Europe and South Africa. MATERIAL AND METHODS: A total of 90 consecutive patients underwent either brachytherapy alone or brachytherapy in combination with external beam radiotherapy for prostate carcinoma between July 2008 and February 2014 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were classified as low-risk, intermediate, and high-risk according to the National Comprehensive Cancer Network (NCCN) criteria. All low-risk and some intermediate risk group patients were treated with seed implantation alone. Some intermediate and all high-risk group patients received brachytherapy combined with external beam radiotherapy. RESULTS: The median patient age was 64.0 years (range 46-78 years). The median follow-up was 58 months (range 18-74 months). Twelve patients experienced biochemical failure including one patient who had evidence of metastatic disease and died of prostate cancer. Freedom from biochemical failure rates for low, intermediate, and high-risk cases were 95.4%, 90.9%, and 70.8%, respectively. Clinical parameters predictive of biochemical outcome included: clinical stage, Gleason score, and risk group. Pre-treatment prostate specific antigen (PSA) was not a statistically significant predictor of biochemical failure. Sixty-nine patients (76.6%) experienced grade 1 urinary symptoms in the form of frequency, urgency, and poor stream. These symptoms were mostly self-limiting. Four patients needed catheterization for urinary retention (grade 2). One patient developed a recto urethral fistula (grade 3) following banding for hemorrhoids. CONCLUSIONS: Our results compare favorably with those reported by other institutions with more extensive experience. We believe therefore that, interstitial permanent brachytherapy can be safely and effectively performed in a resource challenged environment if adequate training and proctoring is provided.