Correlation between prostate volume measured by ultrasound and symptoms severity score in patients with benign prostatic hypertrophy in Southeastern Nigeria.

Background: Benign prostatic hypertrophy (BPH) is a common urological condition in men older than 50 years. It is important in the aetiologies of life-threatening obstructive uropathies. Ultrasound measurement of prostate volume is non-invasive, easily available, and a cost-effective method, useful in assessing bladder outlet obstruction (BOO). The International Prostate Symptoms Score (IPSS) on the other hand objectively assesses symptoms severity in BOO patients. Aim: This study was aimed at determining the correlation between ultrasound-measured prostate volume and IPSS in men with BPH. Patients and Methods: Following ethical approval from the Nnamdi Azikiwe University Teaching Hospital Ethical Committee, 100 patients who met the inclusion criteria and were diagnosed with clinical BPH were enrolled into the study. They had no other identifiable cause of BOO except BPH after clinical evaluation. The IPSS, Quality of life score (QOL), and prostate volumes were measured. Correlation between prostate volume, IPSS, and QOL were done using SPSS version 20. P value <0.05 was considered significant. Results: The mean age of patients was 69.3 ± 10.6 years with a range of 48-100 years. The mean prostate volume, IPSS, and QOL were 96.0 ± 70.5 cm3, 15.63 ± 8.6, and 4.8 ± 1.3, respectively. The highest recorded IPSS was 35 and the lowest was 4, whereas the smallest and largest recorded prostate volumes were 19 cm3 and 350 cm3, respectively. Nocturia was the major IPSS subscore. There was a weak positive correlation between prostate volume and IPSS in men with BPH (r = +0.109; P = 0.28) and between prostate volume and QOL (r = +0.072; P = 0.45). There was also a weak positive correlation between patients with only severe symptoms and corresponding prostate volumes (r = +0.122; P = 0.125). The correlation between patients with severe symptoms and their corresponding QOL was strong (r = +0.537; P = 0.135, respectively). These findings were, however, not statistically significant. Conclusion: There is a weak positive correlation between prostate volume measured by ultrasound and symptoms severity scores in patients with BPH, although not statistically significant. This may be as a result of the small sample size. A larger sample size may be able to achieve statistical significance.

Correlation between intravesical prostatic protrusion and international prostate symptom score among Nigerian men with benign prostatic hyperplasia.

BACKGROUND: Intravesical prostatic protrusion (IPP) is a noninvasive test that can predict bladder outlet obstruction in patients with benign prostatic hyperplasia (BPH). OBJECTIVE: The objective of this study was to determinethe correlation between IPP and International Prostate Symptom Score (IPSS) in patients with BPH. PATIENTS AND METHODS: A cross-sectional prospective study of new patients with symptomatic BPH who presented to the urology clinics of NAUTH, Nnewi. Ethical approval and informed consent were obtained. Participants had abdominal ultrasonography measurements of IPP from midline sagittal image of the prostate (at bladder volume ≥100 mL) using Prosound SSD3500 with abdominal probe frequency of 3.5 MHz. IPP was divided into three grades (grade I: 0-4.9mm, grade II: 5.0-9.9 mm, and grade III: ≥10.0 mm). Data were analyzed using SPSS version 20. The data were subjected to analysis of variance, and Pearson's correlation was used to assess correlation where necessary. P value < 0.05 was considered significant. RESULTS: In all, 101 men with a mean age of 67.09 ± 10.93 years were included in the study. The average IPSS, storage symptoms IPSS (IPSS-S), voiding symptoms IPSS (IPSS-V), Quality of Life (QoL) index, and IPP were 17.05 ± 7.62, 7.81 ± 5.17, 9.24 ± 3.16, 4.75 ± 1.59, and 13.50 ± 7.47 mm, respectively. There were significant differences between the mean IPSS (P = 0.000), mean IPSS-S (P = 0.000), and mean IPSS-V (P = 0.002) among the three grades of IPP. There were significant positive correlations between IPP and IPSS (P = 0.000), IPSS-S (P = 0.000), IPSS-V (P = 0.000), and IPSS QoL index (P = 0.000). CONCLUSION: There were significant positive correlations between IPP and IPSS, IPSS-S, IPSS-V, and IPSS QoL index.

MISSILE AND BLAST INJURIES IN NIGERIA - THE SOUTHEAST EXPERIENCE.

BACKGROUND: Missile injuries occupy a large segment of injuries treated in Southeast Nigeria, accounting for a significant proportion of morbidity and mortality. However, blast injuries are uncommon in this region. This study became necessary as a result of the rising spate of violence in various parts of Nigeria, particularly in the Northeast and in the Niger Delta regions, as well as the ever-present fear of kidnappers, armed robbers and occasionally, trigger-happy security agents. AIM: To determine the types of missile and blast injuries in Southeast region, the circumstances that led to them, the management of the patients, and the outcome. DESIGN OF THIS STUDY: This is a collaborative, retrospective multi-centre study. Setting: 1. Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State. 2. Imo State University Teaching Hospital, Orlu, Imo State 3. Abia State University Teaching Hospital Aba, Abia State. 4. Federal Medical Centre, Owerri, Imo State. 5. University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, all in the Southeast of Nigeria. METHODOLOGY: Patients who were treated for missile or blast injuries in the last five years in each of the collaborating institutions were studied to determine the pattern of such injuries, causes, management options and outcome. RESULTS: Four thousand, two hundred and sixteen (4,216) patients were admitted with missile and blast injuries in the collaborating Institutions in a period of five years. Majority of the injuries (4,177{99.1%}) were from gunshots, mainly to the limbs. The 39 (0.9%) cases of blast injuries were from land mines, hand grenades, and the Biafran type of improvised explosive device, popularly known as "Ogbunigwe". Seven hundred and seventy-two (18.3%) of the patients signed against medical advice and went to traditional bone-setters. Of the remaining 3,444 patients, 3,432 (99.7%) had good outcome. However, there were a total of 12 (0.4%) deaths, four from fulminant sepsis; eight from unknown causes. CONCLUSION: Missile injuries account for a significant proportion of injuries treated in the Southeast of Nigeria; only a few were blast injuries. The outcome of management of the affected patients was satisfactory.

Accuracy of Prader orchidometer in measuring testicular volume.

BACKGROUND: Seminiferous tubules comprise 80-90% of testicular mass. Thus, the testicular volume is believed to be an index of spermatogenesis. Therefore, accurate testicular volume is one way to assess testicular function. OBJECTIVE: To determine the accuracy of Prader orchidometer for measuring the testicular volume by comparing the resultant measurement with the actual testicular volume in humans. MATERIALS AND METHODS: The testicular volumes of 121 testes from 62 patients with prostate cancer (mean age 72.74 ± 9.38 years) were measured using Prader orchidometer before therapeutic bilateral orchidectomy. The actual testicular volumes were then determined by water displacement of the testis. RESULTS: The mean testicular volume of the 121 testes was 10.60 ± 3.5 ml and 13.26 ± 5.2 ml for water displacement and Prader orchidometer measurements, respectively. A strong correlation was found between the actual testicular volume and volumes obtained by Prader orchidometer ( r = 0.926, P = 0.0001). The Prader orchidometer however, over-estimated the mean actual testicular volume by 2.66 ± 2.37 ml (25.10%). CONCLUSION: The result of this study has shown that measuring the testicular volume by Prader orchidometer overestimates the actual testicular volume.

Cyclical haematuria sequel to uterine myomectomy: a case report.

A thirty-year old married nulliparous lady had a difficult myomectomy done by a general practitioner one year prior to presentation. Two months after the operation, she had her menstruation, but with a concurrent total, painless haematuria. This combination continued for nine months before her family physician referred her to the urological clinic. Full urological work-up revealed an iatrogenic vesico-uterine fistula, but the features were not consistent with those of the classical vesico-uterine fistula syndrome. Transabdominal fistulectomy not only controlled the haematuria but also helped the patient to achieve a viable pregnancy.

'Fracture' of the penis in Enugu, Nigeria.

Eight cases of 'fracture' of the penis in a Negro population over a 5-year period are presented. The majority of the cases occurred on the right side in association with sexual activity. All gave a positive history of sexually transmitted disease. We recommend prompt operative treatment that is aimed at full functional and cosmetic recovery.

Cancer of the ureter in a Negro population.

A 13-year retrospective study of ureteric tumours in an African Negro population is reviewed. The tumour is rare. Seven cases were reported, six of them admitting to smoking over 50 packets of cigarettes per year. All the tumours were of the transitional cell type and prognosis is related to grade and staging. Nephroureterectomy with excision of a cuff of bladder was the treatment given. Follow-up was poor owing to illiteracy.

Gross haematuria in a Negro population: an analysis of 100 adult cases.

One hundred consecutive cases of gross haematuria seen at a Nigerian Urologic Clinic are analysed. The causes were identified in 95 cases. Benign prostatic hypertrophy was the commonest cause accounting for 27% of the cases, followed by trauma and infection. Schistosomiasis was an uncommon cause. The pattern of the distribution of aetiological factors and valuable investigations are discussed.

Bladder tumours in Enugu, Nigeria.

The clinicopathological features of 103 tumours of the urinary bladder are reported; 56.3% were transitional cell and 38.8% were squamous cell carcinoma. The results support a strong association between schistosomiasis and bladder cancer.

Pulmonary radiological findings in hepatoma.

Pulmonary radiological features of 27 patients with a diagnosis of hepatoma were reviewed and compared with 64 controls. Coin shadows, nodular, lymphangitic or hilar node metastases were observed in 50% of the hepatoma cases. Other radiological pulmonary findings in hepatoma included statistically significant elevation of the right hemidiaphragm, double contour of the diaphragmatic silhouette and discoid atelectasis. Left hemidiaphragm changes may occur with left lobe involvement. Double contour of the crest of the diaphragm appeared to be specific and common in hepatoma in this African population. Doming of the diaphragm was not specific to hepatoma.

Synergistic bacterial gangrene and allied lesions: a unified etiological theory.

Synergistic bacterial gangrene is a distressing and destructive mixed infection where early recognition is essential. It is suggested that synergistic bacterial gangrene with its allied states may be manifestations of the same process with a wide spectrum. Prompt and appropriate bactericidal therapy may arrest spread before tissue destruction makes radical and immediate surgical intervention, with its attendant high mortality, inevitable.

Idiopathic granulomatous orchitis.

A case of idiopathic granulomatous orchitis in a 37-year-old Nigerian male is discussed. He presented with a history of pain and swelling of left testis of three weeks duration. A clinical impression of tumor of the testis was made followed by orchidectomy. A systemic review failed to show evidence of any infective proccess. Histology showed non-caseating tuberculoid granulomas replacing the seminiferous tubules.