[Epidemiology, etiology and psychosocial impact of urogenital fistulas in a cohort of 170 consecutive patients managed in three treatment centers in Burkina Faso from 2010 to 2012]. / Aspects épidémiologiques, étiologiques et impact psychosocial des fistules urogénitales dans une cohorte de 170 patientes consécutives, prises en charge dans trois centres du Burkina Faso de 2010 à 2012.

OBJECTIVE: To describe the socio-demographical aspects, etiologies and psychosocial consequences of urogenital fistula patients (UGF) in Burkina Faso (BF). PATIENTS AND METHODS: Descriptive study of a cohort of consecutive patients during a period of 18 months (December 1st 2010 to August 31st 2012) in three centers of treatment in BF. Each patient has had a standardized complete medical observation focused on sociodemographics, clinical finding, past medical history and etiologies of UGF. Some patients had an interview with a psychologist. RESULTS: One hundred and seventy patients with mean age 35 years (minimum: 16, maximum: 70) were enrolled during the study period. The majority of patients were housewives (90.5%, n=152) and illiterates (92.9%, n=158). Among the patients, 62.4% (n=106) lived in rural zones. Obstetrical fistula was the most common cause of UGF (87.6%, n=149) in our study and prolonged labor occurred in 93.3% (n=139) of cases with 17.5% (n=26) who delivered at home. The majority of our cases were vesico-vaginal fistula (70.6%, n=120). Fifty-five patients (32.4%) were divorced after the fistula. The sensation of humiliation and sadness were noted at all the patients who had a psychological evaluation and 87.5% (n=14) of them have had suicidal ideas. CONCLUSION: The UGF are frequent in Burkina Faso and obstetrical etiology is dominant. The physical and psychosocial repercussions are important for the women victims of this pathology. LEVEL OF EVIDENCE: 4.

GIANT BLADDER STONE IN A PATIENT WITH TUMOR OF THE BLADDER: A RARE CO-MORBIDITY.

Bladder stones are considered carcinogenic factor for bladder cancer. Concomitant association between giant bladder stone and bladder cancer is rare. We report a case of giant bladder stone complicated by bladder cancer. Bladder cancer was discovered fortuitously. This association of bladder growth necessitated biopsy of the bladder for histopathological study during cystolithotomy.

[Warm saline enema for reduction of intestinal invagination under the ultrasonographic guidance: preliminary results apropos of 2 cases]. / Désinvagination intestinale par lavement au sérum salé isotonique tiédi sous contrôle échographique: résultats préliminaires à propos de deux cas.

The authors describe the use of isotonic normal saline enema under US guidance in the treatment of acute uncomplicated intestinal intussusception in infants. The technique was successfully used in two patients aged respectively 18 and 16 months, with 11 and 9-month follow-up. The various steps of this technique and the results are analyzed and discussed. It is a valuable alternative to surgical treatment or hydrostatic reduction with opaque x-ray contrast under fluoroscopic guidance.

[Intestinal invaginations in children: 24 cases treated at the Yalgado National University Hospital in Ouedraogo]. / Les invaginations intestinales de l'enfant. A propos de 24 cas traitésau Centre hospitalier national Yalgado-Ouédrago.

We report a retrospective study of 24 cases of acute intestinal invagination in children, accounting for 4.4% of the cases of mechanical intestinal occlusion. More boys than girls were affected (sex ratio of 3:1). Consultation was often delayed, there was a high frequency of occlusive forms and of idiopathic forms (17 of the 24 cases) and the mortality rate was high (1 of the 24 children died). This study demonstrates the importance of ultrasound scans in the diagnosis of this condition.

CLINICO-PATHOLOGICAL FEATURES OF PROSTATE CANCER AT THE UNIVERSITY HOSPITAL YALGADO OUEDRAOGO, OUAGADOUGOU, BURKINA FASO.

BACKGROUND: Prostate cancer is not uncommon in Burkina Faso and presents late, often advanced at presentation as is the case in most countries of West Africa. AIM: To describe the clinical and histopathological characteristics of prostate cancer at the University Hospital Yalgado Ouedraogo, Burkina Faso. PATIENTS & METHODS: We conducted a cross-sectional descriptive study of patients treated at the Urology Department of the University Hospital Yalgado Ouedraogo, Burkina Faso for prostate cancer from March 2012 to May 2013. The parameters studied were patients' demographics, clinical features, PSA, histological diagnosis, tumour grading, management and outcome. RESULTS: In this study, 82 patients satisfied the inclusion criteria within the 15 months period of the study. The mean age was 68.9 years (standard deviation: 9.52) with a range of 49-95 years. They presented with symptoms of lower urinary tract obstruction in 57 (69.5%) patients, and irritative symptoms in 59 (72%) patients. At diagnosis 33 (40.2%) of patients had metastases and the most common metastatic sites were the spine in 18(21. 95%), the ribs in 6 (7.31%) and the pelvis in 5 (6.09%) patients. The mean PSA level was 746 ng/ml with a range of 13 - 9224ng /ml. Advanced T3 and T4 tumors accounted for 25.4% and 73.2% respectively. Adenocarcinoma was the only histological form. Gleason score was less than 7 in 41(49.4 %) cases. Androgen deprivation therapy (ADT) was the treatment for 79 (96.34%) patients. In all, 51 (62.19%) patients received medical ADT while 20 (24.39%) patients underwent bilateral orchiectomy. One patient underwent radical prostatectomy. CONCLUSION: In this environment, prostate cancer is diagnosed at an advanced stage with distant metastasis. It is therefore useful to develop effective screening policy for early detection and better outcome of management.

Les gangrènes des organes génitaux externes masculins. Aspects épidémiologiques et thérapeutiques

Objectif : Décrire les aspects épidémiologiques et thérapeutiques des gangrènes des organes génitaux externes masculins. Matériel et méthodes : Il s'est agi d'une étude descriptive et descriptive sur une période de 5 ans allant du 1er janvier 2007 au 31 décembre 2011 au cours de laquelle nous avons enregistré 47 cas de gangrènes des organes génitaux externes. Nous avons analysé rétrospectivement les 39 dossiers qui étaient complets et exploitables. Résultats : Les gangrènes des organes génitaux externes étaient relativement peu fréquentes, constituaient 3,25% des urgences urologiques. Elles étaient l'apanage du sujet d'âge mur avec un âge moyen de 50,17 ans, tous de sexe masculin. Les patients provenaient majoritairement du milieu rural avec 56,4%. Le délai de consultation était assez long avec une moyenne de 9,69 jours avec des extrêmes de 2 jours et 30 jours. Les facteurs de comorbidité ont été retrouvés chez 46,11% des patients. L'origine cutanée a été retrouvée dans 48,7% des patients. Les prélèvements bactériologiques effectués chez 23 patients ont retrouvé un germe chez 13 patients et avec E. coli comme principal germe (10 cas) et accessoirement Staphylococcus aureus (1 cas), Klebsiella pneumoniae (1 cas) et Proteus mirabilis (1 cas). Au plan de la prise en charge tous les patients ont bénéficié d'un traitement médicochirurgical précédé d'une réanimation médicale. Un débridement large avec nécrosectomie a été réalisé chez tous les patients associé à une triple antibiothérapie d'abord probabiliste puis ajustée en fonction du résultat de l'antibiogramme lorsqu'un germe a été identifié. Tous les patients ont subi une cicatrisation dirigée et une plastie de recouvrement a été réalisée. La gangrène des organes génitaux externes reste une affection grave souvent invalidante avec un long séjour hospitalier. Le taux de mortalité était de 17,95%. Conclusion : Les gangrènes des organes génitaux externes masculins sont assez graves avec un fort taux de mortalité. Elles sont relativement peu fréquentes dans notre contexte et la prise en charge est médico-chirurgicale et doit être multidisciplinaire pour espérer obtenir des résultats satisfaisants