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The Management of Urethral Strictures and Stenoses at the John F. Kennedy Medical Center
Ayun Cassell III,
Bashir Yunusa,
Edet Ikpi,
Swalliho Sheriff,
Weh-Wesseh,
Solomane Konneh
Issue:
Volume 3, Issue 1, June 2019
Pages:
1-5
Received:
6 January 2019
Accepted:
29 January 2019
Published:
19 February 2019
Abstract: Background: A urethral stricture is an abnormal narrowing of the urethra resulting from fibrosis in the surrounding corpus spongiosum. The prevalence is estimated to be 229–627 per 100,000 males and its effects on the quality of life of those with the disease are far-reaching. Documented male-to-female ratio in Port-Harcourt, Nigeria, showed a ratio of 31:1 indicating that urethral stricture is very rare in females. Objective: The objective of the study is to assess the approach and outcome of the management of urethral stricture and stenosis at the John F. Kennedy Medical Center. Material and Methods: This is a 7-month retrospective descriptive study assessing the management of 20 patients with urethral stricture at the John F. Kennedy Medical Center from January 2018 to August 2018. The patient’s medical records were retrieved form the record department and reviewed for age, etiology of urethral stricture, site of urethral stricture, procedure performed and postoperative complications. Result: A total of 20 male patients with urethral stricture or stenosis were included in the study. Study revealed that the predominant etiology of urethral stricture was post-traumatic accounting for 35% (7/20). Gonoccal urethritis caused urethral stricture in 30% (6/20) of patients while instrumentation was 20% (4/20). Most of the post-inflammatory stricture involved the bulbar urethra as well as the penile urethra. Urethral Dilatation 9/20 (45%) and resection plus end to end anastomotic urethroplasty 35% (7/20) were the procedures commonly used to manage urethral strictures mostly the bulbar and bulbo-penile parts of the urethra. Conclusion: Urethral stricture disease is a common cause of urological presentation to the urologist worldwide. Urethral dilatation is most commonly performed for urethral strictures due to its feasibility and much less technical challenge. The failure rate is nonetheless high therefore, urethroplasty remains the standard option if possible. Appropriate traffic regulations, judicious use of catheters and proper treatment of urethritis could reduce the incidence of urethral stricture disease.
Abstract: Background: A urethral stricture is an abnormal narrowing of the urethra resulting from fibrosis in the surrounding corpus spongiosum. The prevalence is estimated to be 229–627 per 100,000 males and its effects on the quality of life of those with the disease are far-reaching. Documented male-to-female ratio in Port-Harcourt, Nigeria, showed a rati...
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Overview Percutaneous Nephrolithotomy - A Case Report 32-Year-Old Male with Renal Calculi
Ayun Cassell III,
Mohamed Jalloh,
Abdurama Diallo,
Issa Labou,
Lamine Niang,
Serigne Gueye
Issue:
Volume 3, Issue 1, June 2019
Pages:
6-9
Received:
6 January 2019
Accepted:
29 January 2019
Published:
19 February 2019
Abstract: Surgical management of renal tract stone disease has evolved during the last two decades after the introduction of minimal invasive techniques. Percutaneous nephrolithotomy (PCNL) has become a common procedure performed in patients with renal calculi. Nevertheless, the learning curve is steep and most facilities in subsaharan African lacks this novel minimally invasive approach. Therefore, the PCNL procedure is clearly illustrated in this review using a Case Report of a 32 year old Mauritania Male with a 2 cm renal calculi. With standardized technique and the proper equipment, PCNL can achieve excellent stone-free rates and with minimal patient morbidity.
Abstract: Surgical management of renal tract stone disease has evolved during the last two decades after the introduction of minimal invasive techniques. Percutaneous nephrolithotomy (PCNL) has become a common procedure performed in patients with renal calculi. Nevertheless, the learning curve is steep and most facilities in subsaharan African lacks this nov...
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Clinical and Pathological Aspects of the Sequelae of Urogenital Schistosomiasis: Findings Regarding 43 Cases
Boubacar Fall,
Yaya Sow,
Aboubacar Traoré,
Cyrille Ze Ondo,
Mouhamedou Diagana,
Alioune Sarr,
Babacar Sine,
Samba Thiapato Faye,
Modou Ndiaye,
Ousmane Sow,
Mamadou Ba
Issue:
Volume 3, Issue 1, June 2019
Pages:
10-14
Received:
28 April 2019
Accepted:
2 June 2019
Published:
12 June 2019
Abstract: Purpose: To describe the clinical-pathological profile of sequelae of urogenital schistosomiasis. Patients and methods: We performed a retrospective study of the sequelae for cases of urogenital schistosomiasis treated between January 2011 and December 2016. These cases were from Senegal and neighboring countries. Results: We included 43 cases. The mean age of the patients was 43.2 ± 16.6 years (14 - 75 years). The sex ratio was 3.3. The sites of the sequelae lesions were the bladder and pelvic ureters in 83.7%, the bladder only in 13.9%, and the ureters only in 2.3% of the patients. Bladder wall calcification was the most common lesion (74.4%), followed by bladder masses (48.8%). Stenosis of the orifice was the most common ureteral lesion (30.2%). The bladder masses were a squamous cell carcinoma in ten cases, a urothelial carcinoma in one case, and a schistosomiasis granuloma in five cases. In one patient, the histological type was not specified. Of the ten cases of squamous cell carcinoma, eight had died of cancer. Of the twelve cases of ureteral orifice stenosis treated by ureterocystoneostomy, the outcome was good in nine cases and poor in three patients. Conclusion: In this study, sequelae of urogenital schistosomiasis were most often observed in young adult males. The most common sequelae were vesical and ureteral calcifications, bladder cancers, and pelvic ureter strictures.
Abstract: Purpose: To describe the clinical-pathological profile of sequelae of urogenital schistosomiasis. Patients and methods: We performed a retrospective study of the sequelae for cases of urogenital schistosomiasis treated between January 2011 and December 2016. These cases were from Senegal and neighboring countries. Results: We included 43 cases. The...
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Management of Undescended Testis in Children in Aba Nigeria
Samuel Chidi Ekpemo,
Chukwuemeka Onyearugha
Issue:
Volume 3, Issue 1, June 2019
Pages:
15-17
Received:
21 May 2019
Accepted:
3 July 2019
Published:
10 August 2019
Abstract: Introduction: The anomalies of descent of the testes are common problem in newborn male infants. An absence of the testis in the scrotal sac is defined as cryptorchidism. Ectopic testis occurs when it migrates from its usual path of descent to lie in an unusual location. it affects 2–5% of the infants at birth and 1–2% of them at 3 months of age, the incidence is even higher in preterm infants, reported at 30%. Methodology: This was a prospective cross-sectional study of all male children above 3 months of age with undescended testes who were managed by the Paediatric Surgery Unit of the Abia State University Teaching Hospital Aba from January 2016 to December 2018. Results: Thirty children aged ≤ 15 years with 40 undescended testes managed in 3 years The age at surgery was fourteen months to 15 years (median six years); five (17%) had correction before two years, 10 (33%) before five years and 15 (50%) at age ≥ 5 years. Thirty (75%) testes were palpable and ten (25%) non-palpable. Evaluation was mainly clinical. Ultrasonography was performed for six non-palpable testes but was not helpful. Laparoscopy was not used in any patient. The condition was unilateral in twenty (67%) and bilateral in ten (33%). Forty per cent of the testes were in the inguinal canal, 25% at the external ring, and 15% each at the internal ring and abdomen respectively. Six (20%) testes were macroscopically atrophic (canalicular three, abdominal two, internal ring one). Orchidopexy was performed for 34 undescended testes and orchidectomy forsix testes. Groin and scrotal haematoma developed following one orchidopexy. Following orchidopexy, two (6%) testes retracted necessitating repeat surgery. Conclusion: There is a need to educate parents, traditional birth attendants, midwives and doctors in our sub-region to ensure earlier presentation and treatment.
Abstract: Introduction: The anomalies of descent of the testes are common problem in newborn male infants. An absence of the testis in the scrotal sac is defined as cryptorchidism. Ectopic testis occurs when it migrates from its usual path of descent to lie in an unusual location. it affects 2–5% of the infants at birth and 1–2% of them at 3 months of age, t...
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Correlation Between Matermind-Like Domain Containing 1 (MAMLD1) Gene Mutation with Hypospadias Incidence
Safendra Siregar,
Bambang Sasongko Noegroho,
Irfan Firmansyah
Issue:
Volume 3, Issue 1, June 2019
Pages:
18-21
Received:
18 December 2018
Accepted:
22 August 2019
Published:
9 September 2019
Abstract: Introduction: Hypospadias is a condition in which the urethral orifice is located on the ventral side of the penis proximal to the tip of the glans, from the balanopreputial sulcus to the perineal area. The gene thought to play a role in the occurrence of hypospadias was the mastermind-like domain gene containing 1 (MAMLD1) or previously known as the CXorf6 gene (chromosome X opens reading frame 6). Aims: This study aims to look at the relationship between the gene mutation of MAMLD1 with hypospadias incidence. Methods: This study is observational analysis with case-control as design studies. The subjects are male patients who diagnose as having hypospadias based on examinations conduct at the Department of Urology Dr. Hasan Sadikin Bandung. The study will be conduct in May 2018 - April 2019. DNA is taken from the skin of penile prepuce in both the case group and the control group. DNA extraction using the Homebrew method at the Eykman Laboratory, Padjadjaran University, Bandung. Mutation analysis will carried out by exon sequencing of MAMLD1 coding using the direct sequencing standard method at the Eykman Genetic Laboratory, Padjadjaran University, Bandung. The data that has been obtained will be analyzed using the chi-square correlation test method, if the chi square requirements are not met, then use the fisher test exact. Results: Average age of patients operated was between 4 – 18 years old and the most frequent type of hypospadias was distal Type. No MAMLD1 polymorphisms were found in experimental group and control groups. Result of MAMLD1 gene sequencing showed there were no mutation in any sample. In other words, from all hypospadias and control patient who were sequenced, the mutation rate was 0%. Conclusion: From this study we concluded that MAMLD1 gene mutation were not different between hypospadias and control groups. We didn’t found any MAMLD1 mutation ether in hyposphadia groups or control groups. There was no correlation between MAMLD1 gene mutation with hypospadias incidence.
Abstract: Introduction: Hypospadias is a condition in which the urethral orifice is located on the ventral side of the penis proximal to the tip of the glans, from the balanopreputial sulcus to the perineal area. The gene thought to play a role in the occurrence of hypospadias was the mastermind-like domain gene containing 1 (MAMLD1) or previously known as t...
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Optimizing the Treatment Options for Metastatic Castration Resistant Prostate Cancer in a Resource Poor Setting: A Single Centre Experience
Olufunmilade Omisanjo,
Olawale Ogunremi,
Olufemi Ojewuyi,
Fatai Balogun,
Mofeyisayo Omorinde,
Stephen Ikuerowo
Issue:
Volume 3, Issue 1, June 2019
Pages:
22-26
Received:
18 May 2019
Accepted:
24 August 2019
Published:
16 September 2019
Abstract: Background: Metastatic Castration Resistant Prostate Cancer (mCRPC) is invariably a terminal disease. Though international guidelines exist on mCRPC management, there are varied practices regarding the sequencing of limited available treatment options locally. Objectives: To describe the treatment sequence and outcome of management of mCRPC at the Lagos State University Teaching Hospital, Ikeja over a 4 year period. Methods: This was a retrospective study in which the clinical records of all patients diagnosed with mCRPC at the Lagos State University Teaching Hospital, Nigeria between June 2012 and June 2016 were retrieved and analyzed. Results: There were 30 patients with mCRPC within the study period. The mean age of the patients was 69years. There was a biochemical confirmation of castration resistance in most of the patients (86.7%). The mean serum Prostate Specific Antigen (PSA) at the time of diagnosis was 771ng/ml and the mean Gleason Score was 8. Antiandrogen withdrawal/substitution was the most common first line of management (72.4%), while the use of docetaxel based chemotherapy (36.8%) was the most common second line treatment. Only 13.3% were treated with the newer agents abiraterone and enzalutamide. Almost half of the patients (46.7%) needed additional treatment with radiotherapy and/or zoledronic acid for symptomatic osseous metastases. Antiandrogen withdrawal/substitution was not significantly associated with increased risk of death at 18 months. Conclusion: Appropriate optimization and sequencing of the limited available treatment options for mCRPC are vital to a satisfactory outcome in a resource poor setting. Antiandrogen withdrawal/substitution should be a consideration in the management of mCRPC patients in resource poor environments.
Abstract: Background: Metastatic Castration Resistant Prostate Cancer (mCRPC) is invariably a terminal disease. Though international guidelines exist on mCRPC management, there are varied practices regarding the sequencing of limited available treatment options locally. Objectives: To describe the treatment sequence and outcome of management of mCRPC at the ...
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