Familial occurrence of cryptorchidism.

A case of Cryptorchidism involving a father and all his four sons who are product of a nonconsanguineous marriage has been described. From a review of the literature, as well as evidence derived from the family history, it is suggested that the mode of inheritance may be autosomal dominant with incomplete penetrance or multifactorial.

Femoral hernia in Ilesa, Nigeria.

A prospective study was carried out at Wesley Guild Hospital, Ilesa, Nigeria between 1977 and 1981 on femoral hernia with the following objectives: (a) to determine the incidence of femoral hernia in our hospital; (b) to study the clinical presentation of our patients with particular emphasis on strangulation and to compare these findings with those reported in the caucasian population; and (c) to assess the efficacy of the two commonly used surgical therapeutic measures adopted in the management of this condition. Our findings were: (a) the incidence of femoral hernia in our hospital was 12 per 1,000,000; (b) the peak age distribution was in the 40-60 years age groups. Males were more afflicted than females. Eighty point three percent of our patients had simple femoral hernia, and the prevalence of strangulation in our series was 5.9 percent; (c) no statistically significant difference was noted in the use of either the low or high femoral herniorrhaphy in the treatment of this condition. The main contraindication to the use of the low approach are strangulated femoral hernia, and where a femoral hernia exists with an ipsilateral inguinal hernia.

Anterior transposition of the third part of the duodenum in the management of chronic duodenal compression by the superior mesenteric artery.

Transposition of the third part of the duodenum anteriorly to the superior mesenteric vessels was performed in ten patients with chronic duodenal obstruction due to compression by the superior mesenteric artery (SMAS). Follow-up evaluation showed that all the patients (a) had complete relief of their preoperative symptoms, (b) could tolerate normal diet postoperatively and (c) gained weight rapidly following surgery. There were no major complications or deaths among the patients so treated. The Author feels that this technique is more direct approach, aimed at permanently circumventing the obstruction for these groups of patients selected on the basis of the radiological, pathological and operative findings. The success encountered with the patients so treated would seem to confirm this impression.

Bacterial prostatitis: an unusual cause of total urinary incontinence and its surgical management.

A case of total urinary incontinence as a late sequela of bacterial prostatitis is reported. The etiology of the incontinence and its surgical management are discussed. The patient is continent and is gainfully employed.

The effects of Schistosoma haematobium infestation on the vermiform appendix: the Nigerian experience.

In a prospective study of 518 consecutive appendices removed at surgery for symptomatic appendicitis, 32 appendices showed evidence of chronic Schistosoma haematobium appendicitis (a frequency of 6.2%). As the diagnosis can only be confirmed by histology of the removed appendix, the authors believe that in endemic areas chronic S. haematobium appendicitis may not be as rare as the few recorded cases would seem to suggest. Appendiceal mucosal ulceration with chronic inflammatory infiltration and fibrosis of the appendiceal wall leading to chronic appendicitis may be due to intense deposition of ova in the appendix wall, particularly the submucosa, by the adult worm.

Thyroglossal cysts and sinuses in Ilesa, Nigeria--a 20 year experience.

The English literature is scarce on lesions of thyroglossal duct remnants in the tropics. This prompted the study of cases seen in our hospital over a 20 year period (1961 to 1980). Our findings showed that these lesions are not as rare in the tropics, as current literature would seem to suggest. The presentations of cases and results of surgery are similar to reports dealing with Caucasian populations.

The incidence of contralateral patent processus vaginalis in unilateral inguinal hernia in Nigerian children.

A prospective study was carried out to determine the incidence of contralateral patent processus vaginalis in unilateral inguinal hernia in Nigerian children. Over a 5-year period (1977-1981), all children under 8 years of age with unilateral inguinal hernia underwent planned bilateral groin exploration. The highest frequency was recorded in the under 1 year age group (39%); there was a steady decline with age: at 2 years 22% and beyond 2 years of age it levelled out to 17%. Beyond the age of 5 years, contralateral groin exploration was negative. The frequency in Nigerian children is lower than in their Caucasian counterparts; this may be due to genetic and/or environmental factors.

One-stage bilateral inguinal herniorrhaphy in the adult.

Between 1977 and 1981, the author treated 141 consecutive patients with uncomplicated bilateral inguinal hernia by one-stage bilateral herniorrhaphy. He has compared the results with those from 141 comparable age-matched patients with unilateral hernia treated over the same period. There was no increase in morbidity with the one-stage bilateral procedure. There were no deaths in either group. One-stage bilateral herniorrhaphy has several advantages: (a) only one anesthetic and operating session are required, thus saving the patient the stress of waiting for a second operation, and there is considerable financial saving to the patient; (b) more efficient use is made of hospital beds; and (c) the small risk of strangulation on the unoperated side is avoided.

Histological changes in the testis following adult orchidopexy for unilateral cryptorchidism.

In 10 adult male patients operated on for unilateral cryptorchidism, the testis was located in superficial inguinal pouch in 2 patients; intracanalicular in 5, and intraabdominally in 3 patients. Orchidopexy was performed on 8 patients; and orchiectomy on 2 patients for severe testicular atrophy. Normal spermatogenic function were found in 3 patients postoperatively. The best functional, anatomical, and cosmetic results were achieved in patients whose testis were located in the superficial inguinal pouch; while the worst results were found in intraabdominally located testis. A plea for early diagnosis and treatment of this entity in the tropics is reemphasized.