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1.
Nucl Med Mol Imaging ; 56(2): 96-101, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35464673

RESUMO

Objective: There is a paucity of information on bone scanning for prostate cancer from low-resource countries. This study evaluated the role of bone scan in the primary staging of newly diagnosed prostate cancer in one such setting. Methods: A retrospective analysis of 126 men with newly diagnosed prostate cancer undergoing an initial staging bone scan between January 2017 and December 2020 was carried out at a regional nuclear medicine center in Nigeria. Bone scan results were analyzed according to age, serum level of baseline prostate-specific antigen (PSA), and Gleason score. Equivocal scans and patients with no Gleason score or baseline PSA were excluded from the analysis. p < 0.05 was said to be significant statistically. Results: Of 111 patients (aged 38-84 years, median 66 years), who met the inclusion criteria, 26 (23%) men had evidence of bony metastases as shown by a positive bone scan. Higher PSA levels and Gleason scores were associated with an increased risk of a positive bone scan, p < 0.001. No patient with a PSA level < 20 ng/mL and a Gleason score of < 7 had a positive bone scan. Conclusion: The role of bone scanning in staging newly diagnosed prostate cancer patients in Nigeria is consistent with global reports. Our study confirms that a bone scan finding is well associated with the risk classification using PSA and Gleason score in our population.

2.
Prostate Cancer ; 2021: 9968570, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34868687

RESUMO

INTRODUCTION: Orchidectomy is the most cost-effective means of hormonal therapy for locally advanced or metastatic prostate cancer (LAMP). However, cost-effectiveness should not detract from health-related quality of life (HRQoL) considerations. Bilateral simple orchidectomy (BSO) has been linked to negative psychometric deficits from an empty scrotum. This study compared the HRQoL, therapeutic efficacy, and cosmetic appeal of BSO with endogenous pseudotesticular techniques of bilateral subcapsular orchidectomy (BSCO) and bilateral-epididymal-sparing orchidectomy (BESO). Research Design. Nigerian patients with LAMP were randomised into three surgical arms: BSO, BSCO, and BESO. Expanded Prostate Cancer Index Composite-26 HRQoL and sociodemographic questionnaires were administered before and three months after orchidectomy. Serum testosterone and PSA were measured at 0, 1, 2, and 3 hours; 7 days; and 3 months postoperatively. Pseudotesticular volumes and cosmetic appeal were assessed at 3 months. RESULT: Sixty-three patients were recruited (24 BSO, 21 BSCO, 18 BESO), 73% of whom were low-income earners. There was no significant difference in the procedure cost nor the PSA or testosterone nadirs achieved over the three-month follow-up period (11.3, 12.6, 15.2 ng/ml (p=0.667) and 0.44, 0.64, 0.79 nmol/l (p=0.603) respectively). Those with pseudotesticles (BSCO, BESO) felt less emasculated (p=0.010). BSCO produced the least sexual bother, highest sexual function, and largest pseudotesticular volumes. The cosmetic appeal scores were similar between groups (77.9 ± 22.8, 81 ± 13.9, and 81.9 ± 22.5, respectively, p=0.858). CONCLUSION: Endogenous pseudotesticular techniques, when compared with BSO, reduce the negative psychological impact experienced by patients without increasing costs. BSCO produced the best pseudotesticular volumes and postoperative sexual function. This study is registered with the ClinicalTrials.gov of the National Institute of Health U.S. National Library of Medicine as TEPSO study, NCT03744494: Comparison of the Therapeutic Efficacy and Patient Satisfaction of Three Techniques of Bilateral Orchidectomy in Prostate Cancer Patients of a Nigerian Sub-population. Registration completed on 16th of November, 2018 (registered retrospectively) NCT03744494.

3.
Niger Med J ; 62(6): 298-304, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-38736511

RESUMO

Background: Prostatic diseases cause significant morbidity and mortality in African men. Most Nigerian patients presenting with huge prostate enlargement are availed open prostatectomy to relieve symptoms of prostatism. Some prostates removed for benign enlargement have indolent cancers that are only discovered after histopathological examination. The incidence of these incidental adenocarcinomas of the prostate varies widely. Methodology: We carried out a 10-year retrospective review of open prostatectomy specimens received in the Department of Pathology, from January 2009 to December 2018. At grossing, a minimum of 6 cassettes were used depending on size, and tissue was taken from representative areas for microscopic examination. The data was analysed for the presence of, and the relationship between, incidental adenocarcinoma of the prostate and clinicopathological parameters in each case using relevant statistical tools in the SPSS version 23. Results: Incidental adenocarcinoma of the prostate was found in 5.7% of 158 open prostatectomy specimens seen during the study period. High-grade prostatic intraepithelial neoplasm (HGPIN) was present in 1.9% of cases. Patients in the 7th and 8th decade accounted for 88.8% of all incidental adenocarcinomas. The mean weight of the excised glands was 89.8g (range10-500g). The weight of the prostate did not predict diagnosis of incidental adenocarcinoma. In-hospital consultation accounted for 66.9% of open prostatectomy samples received in the department but the majority (72.7%) of incidental adenocarcinomas were seen in specimens form external consultations. The tumours were mostly ISUP grade group one tumours. Conclusion: The rate of diagnosis of occult prostate cancer is low with majority of the tumours being well differentiated. Organ weight had no relationship with histological diagnosis. Cases managed outside the teaching hospital were more likely to have incidental prostate cancer.

4.
Clin Case Rep ; 6(9): 1697-1700, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30214744

RESUMO

Urethral steinstrasse is rare. Only a few cases of spontaneous or postinterventional urethral steinstrasse have been reported in pediatric and adult patients. We report a case of a 52-year-old Nigerian man with a secondary urethral steinstrasse, and the treatment options possible, as day case procedures, under caudal anesthesia.

5.
Niger J Surg ; 22(1): 32-6, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27013856

RESUMO

BACKGROUND: Erectile dysfunction is becoming a public health issue with high incidences reported in community studies. OBJECTIVE: To evaluate the characteristics and outcome of treatment in men with erectile dysfunction in a tertiary center in Ibadan southwestern Nigeria. METHODS: Data of men with erectile dysfunction was retrieved between July 2004 and June 2014 and analyzed using SPSS version 16 statistical software. RESULTS: Eighty-nine men with erectile dysfunction were managed which constituted 2% of all urological cases seen during the study period. Their median and mean ages were 39 years and 39.6 ± 1.2SD (range 19-76 years). The peak age incidence at 30-44 years was 41.6% and reduced with increasing age after 65 years to 4.5%. The etiologies were psychogenic in 55%, organic in 27%, idiopathic in 17% and 1% was familial. 67.5%, 31.5% and 3.4% were married, single and separated respectively. Seventy percent neither smoked cigarette nor drank alcohol, 21.3% drank alcohol and 9% took both alcohol and smoked cigarette. Seventy seven and half percent of men presented within 5 years of their symptom. The treatments offered were PDE type 5 inhibitors alone or in combination with psychotherapy or modification of medications. The outcome of these treatments ranged from 89% to 91% success rate. CONCLUSION: The number of men with erectile dysfunction managed in the tertiary hospital is very low though the outcome of treatment is within acceptable range. Increase public enlightenment may encourage increase hospital patronage and access to the available treatments for erectile dysfunction.

6.
BMC Urol ; 12: 31, 2012 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-23134722

RESUMO

BACKGROUND: Secondary urethral stone although rare, commonly arises from the kidneys, bladder or are seen in patients with urethral stricture. These stones are either found in the posterior or anterior urethra and do result in acute urinary retention. We report urethral obstruction from dislodged bladder diverticulum stones. This to our knowledge is the first report from Nigeria and in English literature. CASE PRESENTATION: A 69 year old, male, Nigerian with clinical and radiological features of acute urinary retention, benign prostate enlargement and bladder diverticulum. He had a transurethral resection of the prostate (TURP) and was lost to follow up. He re-presented with retained urethral catheter of 4 months duration. The catheter was removed but attempt at re-passing the catheter failed and a suprapubic cystostomy was performed. Clinical examination and plain radiograph of the penis confirmed anterior and posterior urethral stones. He had meatotomy and antegrade manual stone extraction with no urethra injury. CONCLUSIONS: Urethral obstruction can result from inadequate treatment of patient with benign prostate enlargement and bladder diverticulum stones. Surgeons in resource limited environment should be conversant with transurethral resection of the prostate and cystolithotripsy or open prostatectomy and diverticulectomy.


Assuntos
Divertículo/diagnóstico , Obstrução Uretral/diagnóstico , Cálculos da Bexiga Urinária/diagnóstico , Idoso , Divertículo/complicações , Humanos , Masculino , Obstrução Uretral/etiologia , Bexiga Urinária/anormalidades , Cálculos da Bexiga Urinária/complicações
7.
Arab J Gastroenterol ; 12(2): 99-102, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21684483

RESUMO

BACKGROUND AND STUDY AIMS: Ligation-excision haemorrhoidectomy is considered to be the gold-standard treatment for prolapsed haemorrhoids. The procedure is commonly done under general or regional anaesthesia. This study aimed to assess the feasibility and tolerability of open haemorrhoidectomy under local anaesthesia. PATIENTS AND METHODS: This is a prospective study carried out in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, over a 5-year period. All consenting adult patients with prolapsing haemorrhoids were offered Milligan-Morgan haemorrhoidectomy under local anaesthesia. They were assessed for tolerance and complications. RESULTS: More than 95% of the patients tolerated the procedure with manageable complications. CONCLUSION: Open excisional haemorrhoidectomy under local anaesthesia is feasible, safe and well tolerated in our environment, and may encourage early presentation of patients with piles to hospital.


Assuntos
Anestesia Local/métodos , Anestésicos Locais/administração & dosagem , Sedação Consciente , Hemorroidas/cirurgia , Lidocaína/administração & dosagem , Entorpecentes/administração & dosagem , Hemorragia Pós-Operatória/etiologia , Adulto , Idoso , Canal Anal/patologia , Constrição Patológica/etiologia , Constrição Patológica/patologia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Feminino , Humanos , Ligadura , Masculino , Meperidina , Pessoa de Meia-Idade , Nigéria , Dor/tratamento farmacológico , Dor/prevenção & controle , Pentazocina , Fatores de Tempo , Retenção Urinária/etiologia , Adulto Jovem
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