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Management of Impacted Urethral Calculi: An Uncommon Cause of Acute Urine Retention in North-western Nigeria
Ngwobia Peter Agwu,
Abdullahi Abdulwahab-Ahmed,
Abubakar Muhammadu Sadiq,
Emmanuel Ugbede Oyibo,
Ismaila Arzika Mungadi
Issue:
Volume 4, Issue 1, June 2020
Pages:
1-5
Received:
4 November 2019
Accepted:
12 December 2019
Published:
7 January 2020
Abstract: Urethral stones though rare manifestation of urolithiasis may be primary but mostly are secondary arising from either the urinary bladder or the upper tract. When impacted in the urethra may result in acute urinary retention and difficulty in urethral catheterization. Various treatment modalities are available ranging from initial suprapubic cystostomy and subsequent open surgical or endoscopic procedures as well as treatment of associated urethral pathology. We report our experience in the management of patients with acute urine retention due to impacted urethral calculi in a tertiary hospital. This was a retrospective review of forty patients with impacted urethral stones managed at the Urology Unit, Department of Surgery Usmanu Danfodiyo University Teaching Hospital Sokoto from January 2005 to December 2015. Data were collected from patients’ case notes and entered in to a proforma and analysed using SPSS 20.0 version for Windows. Forty patients comprising of one female (2.5%) and 39 males (97.5%), mean age was 25±17.4 years with a range of 1-63yrs. In twenty patients (50%), attempt at urethral catheterization was not successful. Location of the impacted calculi were meatal 7 (17.5%), distal penile 4 (10%), mid penile 8 (20%), proximal penile 1 (2.5%), bulbar 4 (10%), peno-bulbar junction 3 (7.5%), posterior urethra 11 (27.5%), and bladder neck 2 (5%). Spontaneous extrusion of the calculi occurred in 4 (10%), while expulsion occurred in 2 (5%) after intra-urethral instillation of 2% lidocaine jelly. Other treatment modalities in the remaining patients included; meatotomy 11 (27.5%), open urethrolithotomy 6 (15%), urethroscopy and pneumatic lithotripsy 6 (15%), urethroscopy and stone retrieval 1 (2.5%), urethrolithotomy and urethroplasty 2 (5%), and cystolithotomy 8 (20%). Impacted urethral stone may be a cause of acute urinary retention and failed urethral catheterisation. The stone can pass spontaneously with or without manipulation or can be removed by endoscopic or open technique when spontaneous passage is not successful.
Abstract: Urethral stones though rare manifestation of urolithiasis may be primary but mostly are secondary arising from either the urinary bladder or the upper tract. When impacted in the urethra may result in acute urinary retention and difficulty in urethral catheterization. Various treatment modalities are available ranging from initial suprapubic cystos...
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Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients
Satoshi Fukata,
Hideo Fukuhara,
Shingo Ashida,
Takashi Karashima,
Keiji Inoue
Issue:
Volume 4, Issue 1, June 2020
Pages:
6-12
Received:
5 December 2019
Accepted:
9 January 2020
Published:
21 January 2020
Abstract: Objectives: In this study, we evaluate the clinicopathological independent prognostic factors which to predict IVR in patients who underwent Laparoscopic-assisted radical nephroureterectomy (LRNU) for upper urinary tract carcinoma (UTUC). Methods: Between April 2008 to February 2019, we analyzed 100 japanese patients who were underwent LRNU and 92 patients who were underwent open radical nephroureterectomy (ORNU) at our institutions by retrospectively. The Patients characteristics factors, the clinicopathologic factors were collected. The intravesical recurrence free survival (IVRFS) were analyzed using the Kaplan-Meier method and Univariate and multivariate method by using the Cox proportional hazards regression models were performed to identify independent risk factors for IVR after LRNU. Results: In LRNU group, IVR was observed in 39 cases (39%), and it was not significant difference compare with ORNU (P: 0.36). Tumor location (P=0.002), Tumor size (P=0.001), preoperative urine cytology (P<0.0001), the pneumoperitoneum time (P: 0.0005) and adjuvant chemotherapy (P=0.019) showed significant association with postoperative IVR. In the multivariate Cox hazard models, the tumor location (P=0.0003), positive preoperative urinary cytology (P=0.003), and absence of adjuvant chemotherapy (P=0.003) were independent risk factors for subsequent IVR. There were not associated with smoking, Brinkman index, hydronephrosis and ureterorenoscopy before RNU for IVR. Overal survival (OS) was not significant association for experience IVR (P=0.15). Conclusion: In this study, LRNU was not shown to have a significantly higher IVR compared to ORNU. Patients with ureteral cancer and positive preoperative urinary cytology had a higher risk of IVR after LRNU. The adjuvant chemotherapy was significantly decreased the risk for postoperative IVR.
Abstract: Objectives: In this study, we evaluate the clinicopathological independent prognostic factors which to predict IVR in patients who underwent Laparoscopic-assisted radical nephroureterectomy (LRNU) for upper urinary tract carcinoma (UTUC). Methods: Between April 2008 to February 2019, we analyzed 100 japanese patients who were underwent LRNU and 92 ...
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Effect of Variation of Volume of Injected Water in the Air Sacs of Urinary Catheters on Bladder Spasm After Transurethral Plasmakentic Vaporization of Prostate
Hong Caimei,
Guo Xiaoxia,
Li Qiufeng,
Yang Qi,
Chao Xinghui,
Ba Longhong
Issue:
Volume 4, Issue 1, June 2020
Pages:
13-16
Received:
9 January 2020
Accepted:
3 February 2020
Published:
12 February 2020
Abstract: Objective We aim to explore variation of the injected water volume in the air sacs of indwelling urinary catheters on bladder spasm and blood urine in patients after transurethral plasmakentic vaporization of prostate (TUPKVP). Methods We included 90 patients who had benign prostatic hyperplasia and received transurethral plasmakentic vaporization of prostate in the First Affiliated Hospital of Jinan University from July 2018 to July 2019. They were averagely randomized into three groups: control group, experimental group A and experimental group B. We injected 30 ml of water into the air sacs of urinary catheters of patients postoperatively. At the first day after operation, the water was reduced to 20 ml in experimental group A, 10 ml in experimental group B, and the water volume in control group remained unchanged. The bladder spasm, blood urine and comfort level in three groups were analyzed comparatively. Results Nursing intervention of reducing injected water volume resulted in a lower incidence of bladder spasm in experimental group B than those in other two groups with 10% on the day of surgery, 3.3% at the second day postoperatively and no bladder spasm at the third day after operation. There was a significant difference in the incidence of bladder spasm between the three groups (χ2=19.449, P=0.000; χ2=6.469, P=0.040; χ2=8.314, P=0.013). Blood urine was milder in experimental group B than that in other two groups at the third day postoperatively with significant difference (χ2=6.796, P=0.037). Patients in experimental group B felt more comfortable than those in other two groups with a rate of comfort up to 70%. There was a significant difference in it between three groups (χ2=9.600, P=0.008). Conclusions For patients who underwent transurethral plasmakentic vaporization of prostate, when continuous bladder irrigation and analgesia are withdrawn, reduction of water volume in the air sacs of indwelling urinary catheters to 10ml can relieve the constriction of the bladder outlet and rubbing bladder mucosa and prostatic fossa and thus reduce the incidence of bladder spasm and blood urine and increase comfort level.
Abstract: Objective We aim to explore variation of the injected water volume in the air sacs of indwelling urinary catheters on bladder spasm and blood urine in patients after transurethral plasmakentic vaporization of prostate (TUPKVP). Methods We included 90 patients who had benign prostatic hyperplasia and received transurethral plasmakentic vaporization ...
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Oncological Outcomes and Morbidity of Radical Cystectomy for Bladder Cancer: Experience of a Senegalese Centre
Aboubacar Traore,
Cyrille Ze Ondo,
Alioune Sarr,
Babacar Sine,
Modou Ndiaye,
Abdoulaye Ndiath,
Yaya Sow,
Boubacar Fall,
Babacar Diao,
Pape Ameth Fall,
Alain Khassim Ndoye,
Mamadou Ba
Issue:
Volume 4, Issue 1, June 2020
Pages:
17-20
Received:
5 February 2020
Accepted:
28 February 2020
Published:
10 March 2020
Abstract: The purpose of this paperwork is to assess the oncological findings and the morbidity rate after complete cystectomy in our department. Patients and methods: We conducted a backward and descriptive study during a 80-month-period range from September 2011 to May 2018, in the Urology Department of Aristide Le Dantec Teaching Hospital standing as a referral structure in our country (Senegal). Results: Nineteen patients were included accounting for 13 men and 6 women corresponding to a sex ratio of 2. The mean age was at 58 years old (extremes range from 32 to 77 years old). Radical cystectomy consisted of an anterior pelvectomy and transileal cutaneous ureterostomy by Bricker approach in 6 women, a radical cystoprostatectomy with transileal cutaneous ureterostomy by Bricker approach in 12 men and a radical cystoprostatectomy followed by Studer orthotopic neobladder in 1 patient. Early post-operative morbidity consisted of one case of parietal suppuration (grade I), two cases of evisceration (grade IIIb), one case of digestive fistula (grade IIIb), and uroperitoneal peritonitis (grade IIIb) secondary to suture loosening of the uretero-ileal anastomosis (which occurred in the patient who had Studer neobladder). This patient died in resuscitation ward after surgical repair of the uretero-iliary anastomosis. Late complications were a case of acute pyelonephritis three months after cystectomy and a case of flanged occlusion. Two patients with urothelial carcinoma had received adjuvant chemotherapy using the M-VAC protocol. After an average follow-up of 15 months we recorded 13 deaths, three patients were lost of sight and three others respectively lived 4 years and 2 months, 5years and 8 months and 6years and 8 months after radical cystectomy. Mean overall survival was 15 months (4.2 to 25.8 months) with a median survival of 6 months. The only patient who had Studer neobladder died one week after cystectomy. The mean overall survival after previous pelvectomy was 17.2 months and that after cystoprostatectomy was 15.18 months. Conclusion: This work highlights the very poor prognosis of bladder cancers in our context linked to the advanced stage of tumours at the time of diagnosis, the rarity of endoscopic equipment essential for the diagnosis, treatment and monitoring of bladder cancers, the frequency of radiochemically resistant squamous cell carcinoma, the unavailability of chemotherapy in urothelial carcinoma to enable multimodal treatment, and the heaviness and complexity of radical cystectomy.
Abstract: The purpose of this paperwork is to assess the oncological findings and the morbidity rate after complete cystectomy in our department. Patients and methods: We conducted a backward and descriptive study during a 80-month-period range from September 2011 to May 2018, in the Urology Department of Aristide Le Dantec Teaching Hospital standing as a re...
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Explore: The Value of Prostatic Calculi in Prostate Surgery
Xiao Chuan,
Li Luhong,
Wang Yong,
Yi Zhengjin,
Liu Xiangyu,
Li Suqiong,
Cao Jingzhao,
Tang Ruipeng,
Li Xin,
Wan Li
Issue:
Volume 4, Issue 1, June 2020
Pages:
21-24
Received:
9 October 2019
Accepted:
11 December 2019
Published:
24 March 2020
Abstract: Objective To explore the significance of prostatic calculi in prostate surgery. Methods During the beginning of 2010 to the end of 2017, a retrospective analysis was made of 821 cases of benign prostatic hyperplasia (BPH) with prostatic calculi admitted to our hospital. During 2010 to 2015, transurethral resection of the prostate (TURP) was performed. And then, from 2015 to 2017, it was replaced as transurethral laser vaporization of the prostate (TULVP). There were 5 converted to open. We should remove the prostate tissue til the surgical capsule by electrocision or vaporization. If annular fibrous tissue or prostatic calculi are encountered during the operation, the calculi will be exfoliated, and then stop operation. Results All the operations were successfully completed, with an average times of 47 minutes (22-117 minutes), bleeding of 50ml (15-350 ml), indwelling catheter for 5.7 days (3-10 days), and continuous bladder irrigation for 1.3 days (1-5 days). During the follow-up period of 0.4-5 years, the urination symptoms and quality of life of the post-operation patients were significantly improved. Conclusions Prostate calculi can be used as a marker of the depth of operation for BPH.
Abstract: Objective To explore the significance of prostatic calculi in prostate surgery. Methods During the beginning of 2010 to the end of 2017, a retrospective analysis was made of 821 cases of benign prostatic hyperplasia (BPH) with prostatic calculi admitted to our hospital. During 2010 to 2015, transurethral resection of the prostate (TURP) was perform...
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Urinary Tract Infection Among Prison Inmates in Afara Jail Umuahia
Ezeagwula Divine,
Nwachukwu Ndubuisi,
Nwaugo Victor,
Ulasi Amara
Issue:
Volume 4, Issue 1, June 2020
Pages:
25-29
Received:
17 February 2020
Accepted:
25 February 2020
Published:
8 March 2020
Abstract: Urinary tract infections are the most commonly encountered bacterial infections in clinical practice. It is yet to be fully explored in prisons. We determined the prevalence of urinary tract infection among prison inmates at Afara Jail Umuahia, Nigeria. A cross-sectional study was conducted among 218 prison inmates. Freshly-voided mid-stream urine from each inmate was cultured on MacConkey agar and 5% Blood agar and incubated at 37°C for 24h. Isolates were identified by standard microbiological techniques. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. Data were analyzed using SPSS version 17 package and the Chi-square test. The prevalence of urinary tract infection was 22.0%. The commonly isolated bacteria were Escherichia coli (33.3%), Klebsiella pneumoniae (20.8%), and Staphylococcus aureus (18.8%). Exactly 72.9% of isolates were Gram negative bacilli and 27.1% Gram positive cocci (P<0.05). Gram negative isolates were more sensitive to Gentamicin (97.1%) followed by Zithromax (88.6%). Gram positive cocci showed maximum sensitivity to Ciprofloxacin (92.3%) and Gentamicin (92.3%). All Gram positive cocci were resistant to Tetracycline and Ampicillin. Females were more infected (56.6%) than males (17.9%) (P<0.05). The prevalence of urinary tract infection in Afara prison was 22.0%. Escherichia coli was the commonest isolate. Gentamicin and Ciprofloxacin were the most useful antibiotics and could be used as first line drugs for treatment of Urinary tract infection among prison inmates.
Abstract: Urinary tract infections are the most commonly encountered bacterial infections in clinical practice. It is yet to be fully explored in prisons. We determined the prevalence of urinary tract infection among prison inmates at Afara Jail Umuahia, Nigeria. A cross-sectional study was conducted among 218 prison inmates. Freshly-voided mid-stream urine ...
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Management for Priapism at the National Reference University Hospital Centers (NGRH) and at the Mother and Child Hospital (MCH) in Ndjamena
Mahamat Ali Mahamat,
Kimassoum Rimtebaye,
Clotaire Amkd Yameogo,
Moussa Kalli,
Olivier Ngueringeum,
Mahamat Nour Abakar,
Medjine Tchiroue Arnaud,
Oumar Atti
Issue:
Volume 4, Issue 1, June 2020
Pages:
30-33
Received:
5 March 2020
Accepted:
31 March 2020
Published:
17 April 2020
Abstract: The authors studied therapeutic and evolutionary epidemiological, etiological and evolutionary traits. This is a review of patient records admitted to the surgical emergency departments of National Reference University Hospital Centers (NGRH) and at the Mother and Child University Hospital Centers (MCH) in Ndjamena with priapism that was taken care of from 2006 to 2016. Age, consultation time, etiology, established treatment and outcomes of management were the variables studied. The series involved 31 patients, the average age was 21. The main etiology was sickle cell priapism with 77% of cases. Six (6) patients or 19.3% had a history of prolonged erection. More than half of our patients (52%) had consulted after 72 hours of evolution. The puncture of cavernous bodies was the most widely used therapeutic method (45%). No major postoperative complications were recorded in the management of patients in our series. Sustained detumescence was achieved the same day or the next day in all our patients. Conclusion: Although priapism is rare in Africa, it is characterized by the predominance of sickle cell disease as etiology and the longtime of management in particular.
Abstract: The authors studied therapeutic and evolutionary epidemiological, etiological and evolutionary traits. This is a review of patient records admitted to the surgical emergency departments of National Reference University Hospital Centers (NGRH) and at the Mother and Child University Hospital Centers (MCH) in Ndjamena with priapism that was taken care...
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The Epidemiological, Clinical and Therapeutical Aspects of the Vesico-vaginal Fistula at the National Fistula Treatment Center in N'Djamena
Ache Haroun,
Mahamat Ali Mahamat,
Saleh Abdel Salam,
Haway Cherif,
Mohamed Jalloh,
Lamine Niang,
Serigne Ma Gueye
Issue:
Volume 4, Issue 1, June 2020
Pages:
34-38
Received:
11 March 2020
Accepted:
2 April 2020
Published:
30 April 2020
Abstract: The objective of our study was to report on the epidemiological and etiopathogenic aspects of obstetric fistulas and to evaluate the results of their management at the National Fistula Treatment Centre in N'Djamena (Chad). Patients and Methods: This was a retrospective, descriptive study conducted at the National Fistula Treatment Centre in N'Djamena over a 4-year period from January 2012 to December 2016. Results: The mean age of our patients was 26.38 years with extremes of 12 to 74 years. The majority of our patients were young women aged 12 to 22 years. Of the patients 82.5% resided in rural areas. They were housewives in 88.9% and victims of genital mutilation in 76.8%. 73.6% did not have a prenatal consultation. A vaginal delivery was recorded in 74.9%. Perinatal infant mortality was recorded in 83.2%. Spinal anaesthesia was used in 95.7% of cases. The repair by low way in 93.7%. The success rate in a so-called first-hand fistulas was noted in 88.88%. Conclusion: Obstetrical fistulas is a real public health problem in our countries. Women with fistula are victims of all forms of social exclusion. The most effective means of combating it remains prevention and access to emergency obstetric care.
Abstract: The objective of our study was to report on the epidemiological and etiopathogenic aspects of obstetric fistulas and to evaluate the results of their management at the National Fistula Treatment Centre in N'Djamena (Chad). Patients and Methods: This was a retrospective, descriptive study conducted at the National Fistula Treatment Centre in N'Djame...
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