Intravenous urography findings in women with ureteric fistula.

INTRODUCTION: Ureteric fistula is one of the major morbidities that can arise from pelvic surgeries. It mainly results from gynaecological and obstetric procedures. Intravenous urography is an imaging modality for the upper urinary tract. Its features may be suggestive of ureteric fistula and it is of great value when medicolegal issues arise. It is however expensive and requires expertise. There are other useful and cheap methods for evaluating ureteric fistula including the use of dye test. There is need to determine if IVU (Intravenous urography) should be recommended for women with this disease. The aim of this study was to determine the features of intravenous urography among women with ureteric fistula and therefore determine its relevance in the management of such patients. METHODS: This was a retrospective study conducted at the National Obstetric Fistula Centre, Abakaliki between January 2012 and March 2017. All patients with ureteric fistula during the study period who were assessed with intravenous urography before surgery were included in this study. RESULTS: The mean age was 38 ± 16 years. Twelve (92.3%) were Christians. IVU showed hydroureters in 46.15% hydronephrosis in 53.85%, non-functioning kidney in 46.15% and ureteric stricture in 7.69%. IVU gave an insight into the side with ureteric fistula except in one who had normal result. CONCLUSION: Hydronephrosis, hydroureters and silent (non-functioning) kidneys are features of IVU in women with ureteric fistulas, however these features are not pathognomonic for the disease.

Outcome of open excisional breast biopsies in Abakaliki, South-East Nigeria.

INTRODUCTION: open excisional breast biopsy is a known modality for treatment of breast lumps especially in developing countries. Other sophisticated methods are available for management of breast lumps in more advanced nations. Our aim in this study was to review the outcome of open excision breast biopsies in our setting with a view to improving patient management. METHODS: this study was conducted at the National Obstetric Fistula Centre, Abakaliki, South East Nigeria among women who had excision breast biopsy between January 2015 and December 2016. Data was analysed using Statistical Package for Social Sciences (SPSS), version 21. RESULTS: a total of 107 case folders were reviewed in this study. The mean age of the women was 27 ± 10 years. Overlying breast incision was the preferred route in 78(72.9%), periareolar incision in 28(26.2%), and Gillard Thomas's method (infero-lateral submammary sulcus incision) used in one patient with bilateral multiple breast lumps (0.9%). The complications recorded in this study were haematoma in 3(2.8%), wound infection in 5(4.7%) and wound breakdown in 1(0.9%). Hypertrophic scar was found in 2(1.8%) patients at follow-up. Overall, most patients were satisfied with the aesthetic outcome of their surgery. CONCLUSION: open excision breast biopsy is a useful modality for management of breast diseases in our setting. Complication rates are minimal. Both overlying and periareolar breast incisions results in aesthetically satisfactory scar in our practice. Inferior-lateral sub mammary sulcus skin incision is useful when the lumps are multiple and located at different quadrants of the breast. Appropriate use of drain helps to reduce the incidence of haematoma.