[Management of Hyperprolactinemia at the Hôpital du Mali]. / Prise en charge de l'Hyperprolactinemie à l'Hôpital du Mali.

INTRODUCTION: Hyperprolactinemia, which is a supra-physiological secretion of prolactin, is the most common anterior pituitary disorder encountered in clinical practice. Its incidence and prevalence are poorly defined in Africa and the rest of the world. The objectives were to study the clinical, paraclinical, etiological and therapeutic aspects of hyperprolactinemia at the Mali hospital. METHODOLOGY: This was a 5-year cross-sectional study. Data collection was retrospective (July 2011 to October 2015) and prospective (December 2015 to July 2016). RESULTS: We collected 37 cases of hyperprolactinemia. The sex ratio was 0.85. The average age was 37.32 years with extremes ranging from 15 to 74 years. The clinical picture was dominated in women by amenorrhea (80%), galactorrhea (70%), headache (55%), hypofertility (50%), visual disorders (25%) and in men by decreased libido (64.7%), gynecomastia (47.1%), headache (47.1%), visual disorders (41.2%) and erection disorders (29.4%). Basal prolactinemia was greater than 100ng/ml in 45.9% of patients. Cerebral CT had objectified: 11 cases of macroadenomas and 5 cases of pituitary microadenomas. The main causes of hyperprolactinemia were: prolactin pituitary adenoma (43.24%); hypothyroidism (5.40%) and estrogen-progestin use in 5.40%. For treatment, 64.9% of patients were placed on cabergoline; 27% on bromocriptine and 8.10% on simple clinical and biological monitoring. CONCLUSION: Hyperprolactinemia is a condition that exists in our health care facilities. Clinicians should consider this in the face of galactorrhea amenorrhea or decreased libido. It is also necessary to improve the technical platform for better care.

INTRODUCTION: L'hyperprolactinémie, qui est une sécrétion supra physiologique de prolactine est en clinique le désordre hypophysaire antérieur le plus fréquemment rencontré. Son incidence et sa prévalence sont peu définies, en Afrique et dans le reste du Monde. Les objectifs étaient d'étudier les aspects cliniques, paracliniques, étiologiques et thérapeutiques de l'hyperprolactinémie à l'hôpital du Mali. MÉTHODOLOGIE: Il s'agissait d'une étude transversale de 5 ans. La collecte des données a été rétrospective (juillet 2011 à octobre 2015) et prospective (décembre 2015 à juillet 2016). RÉSULTATS: Nous avons colligés 37 cas d'hyperprolactinémie. Le sex ratio était de 0,85. L'âge moyen était 37,32 ans avec des extrêmes allant de 15 à 74 ans. Le tableau clinique était dominé chez les femmes par l'aménorrhée (80%), la galactorrhée (70%), les céphalées (55%), l'hypofertilité (50%), les troubles visuels (25%) et chez les hommes par la baisse de la libido (64,7%), la gynécomastie (47,1%), les céphalées (47,1%), les troubles visuels (41,2%) et les troubles de l'érection (29,4%). La prolactinémie basale était supérieure à 100ng/ml chez 45,9% des patients. La tomodensitométrie cérébrale avait objectivé : 11 cas de macroadénomes et 5 cas de microadénomes hypophysaires. Les principales causes de l'hyperprolactinémie étaient : l'adénome hypophysaire à prolactine (43,24%) ; l'hypothyroïdie (5,40%) et la prise d'oestroprogestatifs chez 5,40%. Pour le traitement, 64,9% des patients étaient mis sous cabergoline ; 27% sous bromocriptine et 8,10% sous simple surveillance clinique et biologique. CONCLUSION: L'hyperprolactinémie est une pathologie qui existe dans nos structures de santé. Les cliniciens doivent y penser devant une aménorrhée galactorrhée ou une baisse de la libido. Il est aussi nécessaire d'améliorer le plateau technique pour une meilleure prise en charge.

[Obstetrical vesico-vaginal fistula in Guinea: Data analysis of three sites of treatment at Engender Health ONG]. / Fistules vésico-vaginales obstétricales en Guinée : analyse des données de 3 sites de prise en charge de l'ONG Engender Health.

OBJECTIVE: To analyze the management of obstetric vesico-vaginal fistula in the three sites of Engender Health in Guinea. PATIENTS AND METHODS: It was a retrospective study of descriptive type having helped collect 450 cases of vesico-vaginal fistulas in three support sites engender health between January 2008 and December 2011. The variables studied were epidemiological, clinical and therapeutic reasons and treatment outcomes were evaluated after a decline of at least six months. RESULTS: The mean age of onset of the fistula was 25years, ranging from 12 to 55years and 58.8% (n=265) of patients were aged between 18 and 30years. The mean duration of fistula was 11years, ranging from 1 to 38years. Eighty-two percent (n=416) of patients were housewives and 66.4% (n=299) off school. The complex fistula with 66% (n=297) was the most frequent. The treatment consisted of a fistulorraphie after splitting vesico-vaginal in 93.3% (n=420) of cases. Therapeutic results considered after a mean of 8months have resulted in a cure in 79.3% (n=357) of cases, improvement in 4.2% (n=19) of cases and failure in 16 4% (n=74) of cases. CONCLUSION: Vesico-vaginal fistula is a major cause of maternal morbidity in Guinea. The establishment of a real health policy based on sound medical and social structures contributes to its eradication. LEVEL OF EVIDENCE: 5.

[Vectorial transmission of malaria in a village along the Niger River and its fishing hamlet (Kéniéroba and Fourda, Mali)]. / Transmission vectorielle du paludisme dans un village du bord du fleuve Niger et son hameau de pêche (Kéniéroba et Fourda, Mali).

A better understanding of malaria transmission dynamics is an essential element in the development of any targeted vector control strategy. The objective of this study was to better understand malaria transmission dynamics along the Niger River in Sudan savanna zone of Mali. Trough cross-sectional surveys, Anopheline larvae were collected by WHO standard dipping technique, and vector adults by Human Landing and pyrethrum spray catches methods. The vector population was composed of An. gambiae s.l. (> 99%) and An. funestus (< 1%). An. gambiae s.l. was composed of 96% and 98% of An. gambiae s.s. respectively in Kéniéroba and Fourda. An. gambiae s.s. was in majority composed of its molecular form M in both locations. The density of An. gambiae s.l was higher in the dry season in the immediate vicinity of the river (fishing hamlet Fourda) compared to farther inland Kéniéroba. The average infection rate of An. gambiae s.l. was 3.63% and 4.06% in Kéniéroba and Fourda respectively. The average entomological inoculation rate (EIR) during the study period was almost similar in Kéniéroba (0.70 infective bites/person/month) and Fourda (0.69 infective bites/person/month). The means EIRs over each of the rainy season 2006 and 2007 were always higher than the one of the dry season 2007 in both localities, with much smaller amplitude in Fourda than in Kéniéroba. However, the level of the transmission was 2.31 (0.37/0.16) times higher in Fourda than in Kéniéroba during the dry season.We conclude that in Sudan savanna zone of Mali, malaria transmission along the river is continuous throughout the year, but it is more intense in the immediate vicinity of the river during the dry season than during the rainy season in opposition to more distant localities to the river and vector control should not be focused only on the rainy in such setting.

[Clinical aspects and management of the torsion of the spermatic cord: study of 27 cases]. / Aspects cliniques et thérapeutiques de la torsion du cordon spermatique : étude de 27 cas.

OBJECTIVE: To analyze in a retrospective way the clinical and therapeutical aspects of the testicular torsion in our service. PATIENTS AND METHODS: It is a retrospective survey of 15 years, from June 1st, 1993 to May 31 2008 to the urology - Andrology service of Conakry. We have 27 files of patients with torsion of the spermatic cord confirmed to the intervention. A percentage of 70.30% patients were less than 25 years old. RESULTS: The scrotal pain was the most frequent functional sign (96.3%). Only 11 patients (40.7%) have been received before the sixth hour. The swelling of the scrotum, ascended testis and the sign of Prehn were the dominant physical signs. All patients have been operated. The number of spire towers varied from 1 to 3. Twenty-two testes (81.5%) have been judged viable and fixed. With a median follow-up of 60 months, the testes volume of these patients was stable in 20 cases (90.9%). The postoperative course was simple in 96.3% of cases. Twenty-three patients (85.2%) were released within a week. CONCLUSION: Torsion of the spermatic cord remained a dangerous affection because putting in game the vital prognosis of the testis. The only justifiable attitude is the urgent surgical operation.

Efficacy and safety of unboosted atazanavir in combination with lamivudine and didanosine in naive HIV type 1 patients in Senegal.

The use of ritonavir as a protease inhibitor boost is rare in sub-Saharan Africa because a heat-stable formula is not available. We report the results of an open-label pilot trial with unboosted atazanavir in combination with lamivudine and didanosine as first-line therapy conducted in Senegal. Treatment-naive HIV-1 infected adult patients without active opportunistic disease were included. The primary endpoint was the proportion of patients with plasma HIV-1 RNA <400 copies/ml at week 48. Forty patients (12 men and 28 women; mean age +/- SD: 40 +/- 9 years) were included. Treatment was changed during the study for two patients (pregnancy, tuberculosis); one patient was lost to follow-up and one patient died (gastroenteritis with cachexia). At week 48, 78% [95% confidence interval (CI): 65-90%] and 68% (95% CI: 53-82%) of the patients had HIV-1 RNA <400 and <50 copies/ml, respectively (intent-to-treat analysis; not completer = failure). Among the seven patients with HIV-1 RNA >or=400 copies/ml at week 48, five were not compliant; genotyping analysis (n = 4) did not reveal a major mutation for protease inhibitors. The mean CD4 cell count change from baseline to week 48 was +238 +/- 79 cells/mm(3). The combination of unboosted atazanavir with lamivudine and didanosine was efficient and well tolerated in HIV-1-infected patients with results similar to those observed in Northern countries. These results suggest that unboosted atazanavir with its high genetic barrier could be a valuable alternative to NNRTIs in resource-limited countries in some HIV-1-infected patients in case of compliance issues with NNRTIs, intolerance to NNRTIs, resistance mutations to NNRTIs, in women with childbearing potential, or as a maintenance therapy in patients with virological suppression.

[Etiological orientation from the analysis morphological and constitutional of urinary stones in Conakry]. / Orientation etiologique a partir de l'analyse morphologique et constitutionnelle des lithiases urinaires a Conakry.

INTRODUCTION: The epidemiological profile of urinary stones varies from region of the world to another according to food habit and certain enviromental factors. The aim of our study was to establish an etiological approach of the urinary lithiasis collected in Conakry by morphological and constitutional analysis. MATERIALS AND METHODS: It was a prospective study from january 1 rst 2003 to january 1 rst 2004 concerning all the stones collected. They were analysed by binocular magnifying glass and infra red spectrophotometry of Fourier. RESULTS: During the period, 18 patients were observed (14 male, 4 femele) of 27.4 +/- 4 years old (from 2 to 69) living mainly in urban environment. From these patients 28 stones were collected; 12 spontaneously and 16 surgicaly. Their composition were whewellite (36%), struvite (29%), carbapatite (14%), urates (14%) and weddellite (7%). In Conakry stones come mainly from hyperoxaluria and urinary tract infection; hypercalciuria is uncomon. CONCLUSION: The urinary calculations examined among patients show in the adult a prevalence of elements in favour of a hyperoxalurie and a notable context of urinary infections in particular in the child; the pure hypercalciurie remains negligible in Conakry, we plan to lead a thorough work to the national scales.

Les ruptures traumatiques de l'uretre posterieur : analyse de 87 cas au CHU de Conakry

Objectif : Rapporter notre experience dans la prise en charge des ruptures traumatiques de l'uretre posterieur. Patients et methodes : Quatre-vingt-sept patients presentant une rupture traumatique de l'uretre posterieur ont ete traites dans le service d'Urologie-Andrologie du CHU de Conakry de janvier 1988 a decembre 2004. Le contexte traumatique a ete un accident de la voie publique dans 68 (78;2) cas et un accident de travail dans 19 (21;8) cas. Seuls 32 (36;8) des patients ont ete recus dans les 72 heures qui ont suivi le traumatisme; les autres ont ete recus au stade de stenose uretrale constituee. Une fracture du bassin a ete notee chez 56 (64;4) patients. La symptomatologie clinique etait dominee par la retention d'urine dans 62 (71;3); l'uretrorragie dans 59 (67;8) et l'hematome perineal dans 23 (26;4) cas. Resultats : Le traitement a consiste en un realignement sur sonde uretrale en urgence; une reparation uretrale en urgence differee entre le 8e et le 10e jour et une uretroplastie tardive selon qu'il s'agissait d'une rupture recente ou ancienne de l'uretre. Les resultats therapeutiques ont ete bons dans 32 (36;8) et moyens dans 39 (44;8) cas. Une dysfonction erectile a ete notee chez 19 (21;8) patientsConclusion : Le traitement des ruptures de l'uretre posterieur demeure controverse; cependant pour nous; l'uretrorraphie termino-terminale en urgence differee reste la methode therapeutique de choix dans notre contexte devant l'impossibilite de pouvoir realiser un realignement endoscopique et en l'absence de lesions associees severes. Devant des lesions associees graves la refection uretrale passe au second plan cedant la priorite aux lesions engageant le pronostic vital

[Erectile dysfunction and diabetes in Conakry (Guinea): frequency and clinical characteristics from 187 diabetic patients]. / Dysfonction érectile et diabète à Conakry (Guinée): fréquence et profil clinique à partir de 187 observations.

Sexual dysfunction is frequent in the diabetic population. In Africa, medical care for erectile dysfunction is underprovided, profoundly altering the quality of life of the patients. We report the prevalence of erectile dysfunction in 187 diabetic patients followed in the department of Endocrinology of the Conakry teaching hospital. Prevalence was estimated from the French version of the International Index of Erectile Function (IIEF). Erectile dysfunction concerned 90 patients (48%) of whom a severe form was observed in 54%, a moderate form in 35% and a mild form in 12%. The patients who presented erectile dysfunction were significantly older, displayed longer duration of diabetes with more complications (sensorial neuropathy and macroangiopathy) and often took drugs for associated cardiovascular diseases. In 28% of the cases, erectile dysfunction was associated with a decline in libido and in 26% with ejaculation disorders. In conclusion, erectile dysfunction is frequent and severe among diabetic patients in Guinea. The medical staff plays an essential role to initiate early diagnosis, promote psychological support and provide medication, if possible.

[Renal diseases--morbidity and mortality in Nephrology Service, National Hospital Donka]. / Morbidite et mortalite hospitalieres dans le Service de Nephrologie de l'Hopital National Donka.

It is a retrospective study of descriptive type on a 4 years period, from April 1, 1999 to March 31, 2003. The aim was to determine factors bound to morbidity and mortality of renal affections in the Conakry University Hospital Center Nephrology Unit. The study was based on 606 hospitalized patients of whom 21 dialysed. The study's references were age, sex, renal affections frequency, mortality, associated pathologies, hospitalization period, death hours and other factors of cardio-vascular risks (tobacco, alcohol). Patients having answered to the selection criteria were 365 men (60.23%) and 241 women (39.77%) with a sex ratio of 1.51. The average age was 44 +/- 17 years old with extremes of 15 and 95 years old; 16.34% of the patients were aged less than 25 years and 14.03% were more than 65 years old. According to the charge taking, 462 (76.24%) were at their neighbors' charge, only 144 (23.76%) could take themselves in charge for their medical care. According to the received treatment before hospitalization, 357 had consumed decoctions of leaves and roots, 86 consulted a health center. The average period of hospitalization was 13 +/- 9 days with extremes of 1 and 80 days. Nicotine addiction was observed with 183 patients of whom 181 were men and alcoholism with 134 patients of whom 122 were men. Renal affections were chronic renal failure (51%), arterial hypertension (30.36%), chronic kidney disease (8.09%), intense renal failure (7.59%), urinary infections (1.65%), intense kidney disease (0.99%) and kidney cancer (0.33%). Among them, 130 deaths were observed (21.45%). According to the period going on before the medical check up, 24 death occurred 2 weeks after the first symptom, and 106 after more than a month. Considering the hours, 33 death (25.38%) occurred between 8 a.m. and 4 p.m. and 63 deaths (48.47%) between 4 p.m. and 8 a.m.; in 34 cases, the hour was not specified. Mortality was due to chronic renal failure in 97 cases (74.61%), to arterial hypertension in 19 cases (14.62%) and to other affections in 14 cases (0.77%). Infections, diabetes, arterial hypertension and anemia sickle cells were renal risk factors. Morbidity and mortality factors were numerous and varied: medical check up delay, traditional cure, patients 'weak turnover, lack of medical care, lack of required equipment and the absence of popular health education.

Morbidité et mortalité hospitalières dans le service de nephrologie de l'Hôpital National Donka

Il s'agit d'une étude rétrospective de type descriptif sur une période de 4 ans, allant du 01Avril 1999 au 31 Mars 2003. L'objectif était de déterminer les facteurs liés à la morbidité et à la mortalité des affections rénales dans le service de Néphrologie du CHU de Conakry. L'étude a portésur 606 patients hospitalisés dont 21 dialysés. Les paramètres de l'étude étaient l'âge, le sexe, lafréquence des affections rénales, la mortalité, les pathologies associées, le délai de consultation, laprise en charge, le traitement reçu avant l'hospitalisation, la durée d'hospitalisation, les horaires de décès et certains facteurs de risque cardio-vasculaires (tabac, alcool). Les malades ayant réponduaux critères de sélection étaient 365 hommes (60,23%) et 241 femmes (39,77%) avec un sex-ratio de1,51. La moyenne d'âge était de 44 ± 17 ans avec des extrêmes de 15 et 95 ans ; 16,34% des patients étaient âgés de moins de 25 ans et 14,03% avaient plus de 65 ans. Selon la prise en charge, 462 (76,24%) étaient à la charge de leur entourage, seuls 144 (23,76%) pouvaient se prendre en charge pour les soins. Selon le traitement reçu avant l'hospitalisation, 357 avaient consommé des décoctions de feuilles et de racines, 86 avaient consulté un centre de santé. La durée moyenne d'hospitalisation a été de 13 ± 9 jours avec des extrêmes de 1 et 80 jours. Le tabagisme avait été observé chez 183 malades dont 181 hommes et l'alcoolisme chez 134 malades dont 122 hommes. Les affections rénales étaient l'insuffisance rénale chronique (51%), l'hypertension artérielle (30,36%), les glomérulonéphrites chroniques (8,09%), l'insuffisance rénale aiguë (7,59%), les infections urinaires (1,65%) les glomérulonéphrites aiguës (0,99%) et le cancer du rein (0,33%). Parmi eux, 130 décès avaient été observés soit 21,45%. Selon le délai écoulé avant la consultation, 24 décès étaient survenus 2 semaines après le premier symptôme et 106 après plus d'un mois.Suivant les horaires, 33 décès (25,38%) étaient survenus entre 8h et 16h et 63 décès (48,47%) entre 16h et 8h ; dans 34 cas, l'heure n'était pas précisée. La mortalité était due à l'insuffisance rénale chronique dans 97 cas, soit 74,61%, à l'hypertension artérielle dans 19 cas, soit 14,62% et aux autres affections dans 14 cas, soit 0,77%. Les infections, le diabète, l'hypertension artérielle et la drépanocytose étaient les facteurs de risque rénal. Les facteurs de morbidité et de mortalité étaient nombreux et variés à savoir : le retard à la consultation, le traitement traditionnel, le faiblerevenu des malades, l'absence de couverture sanitaire, le manque de prise en charge correct au cours des gardes, le manque d'équipement adéquat et l'absence d'éducation sanitaire populaire

A descriptive, retrospective study of 567 accidental blood exposures in healthcare workers in three West African countries.

We conducted a multi-centre study in West African hospital wards to document accidental blood exposure (ABE) risks in these settings, and assessed the incidence of ABE in participating healthcare workers (HCWs) retrospectively. In total, 1241 HCWs participated in the survey from 43 hospital wards. Among them, 567 (45.7%) had sustained at least one ABE with an estimated incidence of 0.33 percutaneous injuries (PCIs) and 0.04 mucocutaneous contacts (MCCs)/HCW/year in medical or intensive care personnel and 1.8 PCIs/HCW/year in surgeons. The ABE was a needlestick in 454 (80.1%) of 567 cases, a cut in 19 cases (3.4%), a splash or contact with non-intact skin in 87 cases (15.3%), and was undocumented in seven cases (1.2%). The source patient's human immunodeficiency virus (HIV) serostatus was positive in 74 cases (13.1%), negative in 65 cases (11.5%), and unknown in 416 cases (73.4%). The ABE was not notified in the ward in 392 cases (69.1%). Healthcare structures can improve HCWs' safety and reduce the stigma against HIV-infected patients by improving access to training, information, primary prevention (ABE prevention equipment) and secondary prevention (postexposure prophylaxis) of occupational infection risks.

Pied diabétique: facteurs de risque dans le service de diabétologie du C.H.U de Donka

L'objectif de ce travail était de décrire les principales lésions retrouvées et d'identifier les facteurs de risque associés aux lésions du pied diabétique parmi les patients suivis au CHU de Donka. Nous avons réalisé une étude de type cas-témoins dans laquelle 30 patients qui avaient un pied diabétique (cas) ont été comparés à 60 patients diabétiques indemnes de lésion du pied (témoins) selon les caractéristiques de personne, celles du diabète, les facteurs de risque cardiovasculaire et les complications liées au diabète. Les lésions observées étaient l'infection dans 22 cas (62 %), la gangrène sèche dans 9 cas (26 %), l'ostéite dans 3 cas (9%) et le mal perforant plantaire dans 1 cas (3%). Les facteurs de risque du pied diabétique identifiés étaient la neuropathie sensitive (p=0,006), l'artérite des membres inférieurs (p=0,001) et le mauvais équilibre glycémique (p=0,01). Un bon équilibre du diabète associé à une éducation de ces patients à risque podologique élevé, focalisée sur ces facteurs de risque, permettrait de prévenir les lésions du pied

[Quadriceps fibrosis following intramuscular injections into the thigh: apropos of 92 cases at the Ignace Deen Central University Hospital in Conakry]. / Fibrose du quadriceps: séquelles d'injections intramusculaires de la cuisse a propos de 92 cas au C.H.U Ignace Deen de Conakry.

Analysis of 92 cases of quadriceps fibrosis following intramuscular injection into the thigh showed that the most affected age group was 3- to 7-year-old preschool children with a male predominance (68.7%). The most implicated drug (81.7% of cases) was quinine salts after of mean of 2 injections. Stiffness of the knee was the most outstanding clinical sign. In our series, the efficient technique for prompt functional recovery consisted of lengthening the quadriceps tendon by isolated "Z" plasty (56.5% of cases). Administration of drugs in oral, rectal or intravenous forms is the most effective means of prevention.

[Urologic complications of gynecologic surgery. Report of 16 cases]. / Les complications urologiques de la chirurgie gynécologique. A propos de 16 cas.

From 16 cases collected in eight years (January 1991-December 1999) in the I. Deen Teaching Hospital Department of Urology, the authors study the gynaecological and obstetric surgery urological complications. They noted that these complications interest in 80% of cases the 18-47 years old woman with a high parity in 70% of cases. Hysterectomy, whatever the indication is the main etiology: 62.50%, caeserean takes the second place with 25%. The anatomic lesions are ureteral in 68.75% of cases and bladder in 31.25%. In the 14 cases treated, in the department, uretero reimplantation has been done in 46.66%, bladder suture in 40% and nephrectomy in 6.66%. Thirteen women were healed and one died.

[Anatomoclinical study of prostate benign tumors a the urology service of the CHU Ignace Deen]. / Etude anatomoclinique des tumeurs bénignes de la prostate au service d'urologie du CHU Ignace Deen.

OBJECTIVE: It was to compare picture and results of anatomopathological exams of the operated organs, given the individualization of new procedures in recent years. METHODS: One hundred and eighty-two patients, aged from 50 to 98 years, were hospitalized for prostatic tumors. After a complete clinical exam followed by surgery, the operated organs were the subject of a conventional histological study. Data from the rectal touch (RT) were compared with the histological results. RESULTS: In the diagnosis of benignancy, RT and the histology are in agreement in 93% of the cases, though only in 75% of the cases of suspected malignancy. Seven percent of the occult cancers are observed, of which ten cases (6%) are adenocarcinoma at Stage A, and two cases (1%) of carcinoma in situ. We observe as well one case of prostatic localization of leukemia and one case of leiomyosarcoma. Prostatitic-type inflammatory lesions and malpighian metaplasias are very frequent 18 and 7%, respectively). Basal cell hyperplasia is rare. CONCLUSION: The RT keeps its place in the exploration of the prostate, within the framework of individual screening and patient follow-up. Transrectal echography and protein-specific antigen (PSA) dosing are certainly necessary but expensive in our country. Histology, which remains irreplaceable, allows us to make a definitive diagnosis at low cost.

[Endoscopic internal urethrotomy in the treatment of male urethral stenosis at the urology service of the CHU Ignace Deen]. / L'urétrotomie interne endoscopique dans le traitement des sténoses de l'urètre masculin au service d'urologie du CHU Ignace Deen.

The authors report a series of 157 stenoses of the urethra treated by endoscopic urethrotomy between 1991 and 1997. After a first urethrotomy the success rate is 51.8%, with a decline of one year. Mortality is zero, and the morbidity assessed at 9%. For these authors, the result is better when the urethrotomy concerns an uninfected, one-time, short (less than 2 cm) stenosis, whatever the etiology, located on the proximal urethra. The duration of the postoperatory catheter has been fixed at three days. Poor results (35.20%) have been reported in stretched stenoses located on the distal urethra. These poor results have been treated by another urethrotomy, with 25% good results. The remaining 10.2% have needed sessions of urethral dilatation, even a plasty.

[Bladder diverticulosis at a urologic service of the Ignace Deen de Conakry teaching hospital. Retrospective study of 28 cases]. / Les diverticules de la vessie au service d'urologie du CHU Ignace Deen de Conakry. Etude rétrospective de 28 cas.

From January 1st 1993 to December 31st 1998, 28 cases of bladder diverticula have been collected in Ignace Deen teaching hospital department of urology. The purpose of authors is to study the epidemiological aspects of diverticula of the bladder. They noted that bladder diverticula in 96.40% of cases are male disease, diagnosed by cystography, intravenous urography, ultrasonography or cystoscopy in 86%; and the etiology of bladder diverticula is a prostatic tumor in 68% of cases. A diverticulectomy is done by open surgery, associated to relieving outlet obstruction in 42.90%.