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Bladder Cancer in Young Patients: Management and Outcomes

Journal of Cancer Therapy 2022年第3期13卷 168-178页

作者： Cyril Kamadjou divine enoru eyongeta Annie Kameni Achille Mbassi Fru Angwafor Medical and Surgical Center of Urology Douala Cameroon Department of Surgery and Specialities Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Regional Hospital Limbe Limbe Cameroon Medical and Technology Institute University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon

Background and Objective: Bladder cancer frequently occurs between the ages of 50 years and 70 years and rarely occurs before the age of 40 years. It accounts for 1% - 4% of all cases of cancer. This study focuses on the clinical, etiological, histological, therapeutic, and evolutive profiles of patients with bladder cancer aged less than 45 years. Materials and Methods: This retrospective study was carried out over seven years (from January 2014 to December 2020) on 15 patients below 45 years of age who were being treated for bladder cancer. The diagnosis was made in all patients via cystoscopy and abdominal computerized tomography, while the nature, grade, and degree of infiltration were determined via endoscopic resection and pathology. Results: The mean age of the 15 patients in this study was 34.4 ± 5.19 years. In 86.6% of cases, the patients had macroscopic hematuria as the main presenting complaint. Twelve patients (80%) had bladder tumors that did not infiltrate the muscle. These patients were followed up clinically. In 86.6% of cases, there was a single tumor with a mean diameter of 2.53 cm. In four patients (26.6%), mitomycin was started early. The overall rates of tumor recurrence and progression were 26.6% and 20%, respectively. Conclusion: Bladder cancer also occurs in young people, with similar clinical and epidemiological profiles as exists in elderly patients. The prognosis of bladder cancer in young people depends on the treatment method chosen by the physician.

关键词： Bladder Tumor Young Patient Histology Evolution

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Intraluminal Lithotripsy with Rigid Ureteroscopy for Proximal and Distal Ureteral Stones: Results of a Single Center in Cameroon

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Open Journal of Urology 2021年第12期11卷 486-495页

作者： Cyril Kamadjou divine enoru eyongeta Edouard Herve Moby Jerry Kuitche Fru Angwafor Medical and Surgical Center of Urology Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences Department of Surgery and Specialties University of Douala Douala Cameroon Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Coordinator Urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaoundé Yaoundé Cameroon

Aim: To evaluate the efficacy and safety of intraluminal lithotripsy with a pneumatic lithotripter (EMS, Switzerland) and laser Holmium YAG in retrograde rigid ureteroscopy for proximal and distal ureteric calculi. Materials and Methods: This was a retrospective study carried out from January 2015 to December 2019 including 175 patients with ureteric calculi who presented with ureteric colic at a mini-invasive surgical urological center in Douala, Cameroon. All the patients underwent retrograde ureteroscopy with a 7F rigid ureteroscope, and fragmentation was done with either a pneumatic lithotripter or a laser holmium YAG. Six patients who had urinary tract infection benefited from double J stent placement before retrograde ureteroscopy. The study variables included age, clinical symptoms, size and location of the stone, the type of lithotripsy, operating time, and the results of lithotripsy. Results: We included a total of 175 patients with a mean age of 40.95 ± 12.50 years. Seventy-six (43.43%) of our participants were females and all patients had at least one calculus confirmed by a CT scan. Stone sizes ranged from 5 - 26 mm (median of 12 mm). Fifteen (8.57%) stones were located in the upper ureter (pyeloureteric junction), 64 in the middle ureter, 20 in the iliac ureter, 43 in the pelvic ureter, and 33 at the vesico-ureteric orifice. The success rate was 100% for stones located in the iliac ureter, pelvic ureter and the ureteric orifice. For those in the middle and upper ureter, the success rate was 92.18% and 60%, respectively. Conclusion: Rigid ureteroscopy is an excellent treatment modality for ureteral calculi, especially those located at the distal part of the ureter. The procedure is associated with a shorter operation time and a shorter post-operative hospitalization period, in addition to its safety and effectiveness compared to open surgery.

关键词： Calculi Rigid Ureteroscopy Pneumatic Lithoclast Laser Holmium Double J Stent

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Laparoscopic Transperitoneal Pyeloplasty for Ureteropelvic Junction Obstruction: Preliminary Results from 26 Cases

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Surgical Science 2023年第5期14卷 309-320页

作者： Cyril Kamadjou divine enoru eyongeta Annie Kameni Wadeu Patrick Fotso Gwabap Bertin Njinou Ngninkeu Edouard Hervé Moby Medico Surgical Centre of Urology and Mini Invasive Surgery Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Health and Sciences University of Buea Buea Cameroon Clinic of Aeroport Douala Cameroon

Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Kuss-Anderson technique. Because of the minimally invasive nature of the laparoscopic approach, it has become the approach of choice for the management of this pathology. We present the results of laparoscopic transperitoneal pyeloplasty used in the management of PUJS. Materials and Methods: This was a retrospective study from 2015 to 2020, including 26 patients who underwent laparoscopic transperitoneal pyeloplasty for PUJS. Results: Twenty-six patients, including 18 (69.2%) men and 6 (30.8%) women, with a mean age of 35.42 ± 13.62 years, were treated. Renal colic was the primary symptom in the majority of the cases (22, 84.6%)). The diagnosis was confirmed in all patients through an abdominal CT scan, which revealed that all 26 patients had hydronephrosis. Half of the patients (50.0%) were classified as Valayer-Cendron Type II, and eight (30.8%) patients had associated stones. Seventeen (65.4%) patients had pathologies on the left side, and all patients were treated using the Kuss-Anderson technique with a median operating time of 108.5 (90.0 - 136.0) minutes. The uncrossing of lower pole vessels was performed in 10 patients. The average duration of hospitalisation was 2.23 ± 0.82 days. No conversion was observed, and after an average follow-up of 53.69 days, the success rate was 92.3%. Conclusion: Laparoscopic pyeloplasty is a minimally invasive technique of choice for the treatment of pyelo-ureteral junction obstruction. It is dependable, repeatable, and produces good functional outcomes that are equal to those of traditional surgery.

关键词： Pyelo-Ureteral Junction Lower Pole Vessel Pyeloplasty Double J Stent

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Transperitoneal Laparoscopic Cystoprostatectomy for Muscle Invasive Bladder Cancer: Results and Oncologic Outcomes in a Single Center in Douala Cameroon

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Surgical Science 2022年第11期13卷 529-540页

作者： Cyril Kamadjou divine enoru eyongeta Annie Wadeu Kameni Herve Moby Mpah Justin Kamga Bertin Njinou Ngninkeu Fru Angwafo Medico Surgical Center of Urology and Mini Invasive Surgery Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences Department of Surgery and Specialities University of Douala Douala Cameroon Regional Hospital Limbe Limbe Cameroon General Hospital Yaounde Yaounde Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon

Background and Aim: Radical cystectomy is the treatment of choice for muscle-invasive bladder cancer. Although open surgery is currently the gold standard for this procedure, it can also be done via laparoscopy. We aimed to evaluate the oncologic results and the place of laparoscopic cystectomy in the management of bladder cancer in a single urology center in Douala, Cameroon. Patients and Methods: This is a prospective, single-center study carried out from 2015 to 2019. We included 12 patients (ten men and two women) with bladder cancer who underwent total radical laparoscopic transperitoneal cystectomy with ilio-obturator lymph node dissection. Data on patients’ demographic characteristics, pre-operative and postoperative clinical parameters and workup results, and surgical outcomes were collected to determine the overall survival using a Kaplan-Meier curve. Results: We recruited ten men and two women with a median age of 61.5 [52.8 - 68.5] years. The mean tumor diameter was 3.75 ± 1.06 cm. Three (25%) patients received adjuvant chemotherapy while eight did not. The mean surgery duration was 242 ± 45.85 minutes. Blood vessels and nerves were preserved in four (33.33%) patients during surgery. Transitional cell carcinoma was found in 10 (83.33%) patients while epidermoid carcinoma was found in two (16.67%) patients. Metastasis occurred in four (33.33%) patients while the tumor recurred in two (16.67%) patients who later died. Bricker’s ileal conduit urinary diversion was performed in 10 (83.33%) patients while the Studer neobladder was used in two (16.67%) patients. The mean duration of hospitalization was 6 ± 1.48 days. Only one patient (8.33%) developed a postoperative complication. Six (50%) of the patients died while six survived. The median overall survival was 486 days and the five-year overall survival rate was 46.47%. Conclusion: Laparoscopic cystectomy is a mini-invasive technique associated with good cancer control. When performed by well-trained staff us

关键词： Laparoscopic Radical Cystectomy Bladder Cancer Overall Survival Urinary Diversion

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Management and Outcome of Urethral Strictures at Two Tertiary Health Facilities in Cameroon

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Open Journal of Urology 2024年第8期14卷 435-446页

作者： Martin divine Mokake divine enoru eyongeta Ekani Mahamat Ekani Diana Nunga Theophile Chunteng Nana Ntungwetape Ngwane Mwambo Nalova Elroy Patrick Weledji Chichom Alain Mefire Marcellin Ngowe Ngowe Department of Surgery and Specialties Faculty of Health Sciences University of Buea Buea Cameroon Department of Surgery Regional Hospital Buea Buea Cameroon Department of Surgery Regional Hospital Limbe Limbe Cameroon Department of Surgery Douala General Hospital Douala Cameroon

Introduction and Objectives: Urethral stricture is a reduction in the caliber of the urethral lumen impeding the outflow of urine. It predominantly affects males. The disease burden is severe in our milieu where access to specialized care is limited. Our goal was therefore to assess the management and outcome of male urethral stricture at two tertiary hospitals in Douala, Cameroon. Materials and Methods: This was a hospital-based retrospective study of patients managed for urethral stricture over 5 years (January 1st, 2017 to December 31st, 2021) at the Douala General and Laquintinie Hospitals. Data on sociodemographic, clinical, paraclinical, and treatment options were extracted using pre-structured forms. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 28. Statistical significance was set at p-value Results: We exploited 130 medical records. The mean age of patients was 46.5 years. Dysuria and weak urine stream were the major presenting complaints (63.8% and 23.8% respectively). The etiology of urethral stricture was iatrogenic in 42.3% of cases. The strictures were mostly single (89.8%), and the bulbar urethra was most affected (46.9%). 28 patients had urinary tract infections and the most frequently isolated germ was E. coli in 29.6%. Direct visual internal urethrotomy (DVIU) was performed in 42.3% of cases. Surgery, especially excision and primary anastomosis (EPA) was done in 28.5% of cases. Major complications were wound infection, acute kidney injury (AKI), and urethrocutaneous fistulae affecting 3.1, 2.3, and 1.5% of cases respectively. The recurrence rate was 17% with a mortality rate of 0.08%. Conclusion: Urethral stricture is common in our adult male population. The cause is mainly iatrogenic and the bulbar urethra is most affected. Minimally invasive and open reconstruction are frequently used treatment options with significant recurrence rates in the long term.

关键词： Urethral Stricture Management Outcomes

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Bipolar Transurethral Prostate Resection: A Study of 112 Cases

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Open Journal of Urology 2022年第2期12卷 117-128页

作者： Cyril Kamadjou Jerry Kuitche divine Enorou eyongeta Achille Mbassi Fru Angwafor Centre Medico-Chirugical d’urologie Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Yaounde Central Hospital Yaoundé Cameroon Coordinator Urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaoundé Yaoundé Cameroon

Background: With the advancement of technology, prostate resection can be performed nowadays using endoscopic techniques, which include monopolar and bipolar transurethral prostate resection. This study aimed to evaluate the results of bipolar transurethral prostate resection in a single urology center in Cameroon. Materials and Methods: This was a retrospective study carried out over two years (2015-2017) involving 112 patients with symptomatic prostate diseases who underwent transurethral prostate resection with the help of a bipolar Olympus generator. Results: The ages of the participants ranged from 44 years to 85 years, with a mean age of 64.41 ± 9.5 years. Fifty-six (50%) patients presented with only obstructive symptoms, five (4.46%) had only irritative symptoms, twenty (17.86%) presented with both obstructive and irritative symptoms, eight (7.14%) presented with macroscopic hematuria, seven (6.25%) with urinary tract infections, and sixteen (14.29%) with acute urinary retention. Digital rectal examination was unremarkable in 74 (66.07%) findings and was positive in 38 (33.93%) patients. The median prostate diameter was 70 [59 - 86.5] mm. The mean preoperative IPSS was 24.46 ± 5.68. The mean surgery duration was 77.61 ± 23.87 minutes. The mean volume of irrigation fluid used during surgery was 24.84 ± 6.40 ml. The differences between the preoperative and postoperative mean IPPS score, maximum urine flow rate, and quality of life were statistically significant (all P Conclusion: Bipolar transurethral prostate resection is a viable alternative to open surgery or laparoscopic surgery for large prostate glands. This technique is also associated with a reduction in prostate-related morbidity.

关键词： Bipolar Transurethral Prostate Resection Prostatism Quality of Life Irrigation Fluid Large Prostate Glands

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Laparoscopic Varicocelectomy: Results and Outcomes in a Single Center in Cameroon

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Open Journal of Urology 2022年第6期12卷 331-341页

作者： Cyril Kamadjou Basile Essola divine eyongeta Emmanuel Muhawenimana Annie Kameni Fru Angwafo Medical and Surgical Center of Urology Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Kigali Teaching Hospital Kigali Rwanda Coordinator Urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Background and Objective: The optimal treatment for varicocele is still controversial. Although there are many treatment methods, none can be considered as the best therapeutic option. We present our initial laparoscopic varicocelectomy experience by describing the clinical aspects and evaluating the outcomes of this surgical procedure at the Centre medico-chirugicale d’urologie in Douala, Cameroon. Materials and Methods: This was a retrospective study carried out between January 2015 and December 2019 on 35 patients with symptomatic varicoceles who were treated for either testicular pain or infertility. All surgical procedures were performed via laparoscopy, with ligation of the spermatic vein using a hemlock clip in the retroperitoneal space. The patients were followed up for three months after surgery, and data were collected and analyzed to obtain results. Results: The study participants were aged 16 - 55 years, with a mean age of 36.11 ± 8.45 years. Infertility was the main presenting complaint. In 65.7% of cases, varicoceles were bilateral with testicular atrophy occurring in 26 patients (74.28%). The surgery duration ranged from 14 minutes to 60 minutes, with an average duration of 34.8 minutes. There was no case of conversion to open surgery. No major complications were observed and all patients were discharged the day after surgery. Three months after surgery, all patients stopped experiencing pain and semen parameters improved in 71.42% of the study participants, with 42.82% of them impregnating their partners. Conclusion: Laparoscopic varicocelectomy is efficient, less time-consuming, with minimal postoperative complications. It can be performed easily in the outpatient department.

关键词： Varicocele Laparoscopic Varicocelectomy Testicular Pain Male Infertility

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Epidemiological, Clinical and Therapeutic Profile of Obstructive Renal Failure

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Open Journal of Urology 2018年第4期8卷 89-92页

作者： Kimassoum Rimtebaye Cyril Kamadjou divine eyongeta Annie Kameni Justin Kamga Bertin Njinou National General Referal Hospital N’Djamena Chad Medico-surgical Center of Urology and Mini Invasive Surgery Douala Cameroon Regional Hospital Limbe Cameroon General Hospital Yaounde Cameroon

Aim: To describe the epidemiological, clinical, etiologic and therapeutic aspects of patients with acute obstructive renal failure at the Medical Surgical Center of Urology (MSCU). Materials and methods: this was a descriptive retrospective study of 106 patient records treated for acute renal failure from January 2012 to December 2016. Patients came for spontaneous consultation or were referred. They had benefited from a clinical and paraclinical assessment at the end of which the diagnosis of acute renal failure was retained and then an effective management at the MSCU. The variables studies were clinical, paraclinical, therapeutic and progressive. The treatment included: hemodialysis, urinary diversion (suprapubic, urethrovesical and ureteral), trans-urethral resection of the prostate, trans-urethral resection of the bladder, nephrostomy, endoscopic incision of catheter valves, posterior urethra or laparoscopic nephroureterectomy as indicated. The emergency treatments consisted of removing the obstacle and the etiological treatment was done later. External follow-up consultation varied by etiology. Results: In 4 years we had treated 106 patients, a frequency of 26.5%. The average age was 47.83 years with extreme of 2 and 80 years old. The sex ratio was 68 men for 38 women. The mean serum creatinine level was 37.8 mg/l (335 μmol/l). The etiologies were: prostatic pathologies (n = 38), lithiasic pathologies (n = 20) and gynecological pathologies (n = 18). The treatments were: endoscopic resection of prostate (n = 24), bladder (n = 6), posterior urethral valves (n = 4), JJ probe (n = 27) and nephrostomy (n = 23). The result was good (normalization of creatinine serum) in 79 patients, the persistence of elevated serum creatinine was observed in 4 patients and 18 patients died. Conclusion: Acute obstructive renal failure is a common diagnosis in our exercise setting at MSCU where it can be managed with respect to our technical platform.

关键词： Renal Failure Nephrostomy Creatinine Endoscopic Resection

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Management of the Valves of the Posterior Urethra in Urology

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Open Journal of Urology 2018年第5期8卷 166-170页

作者： Cyril Kamadjou Kimassoum Rimtebaye divine eyongeta Annie Kameni Justin Kamga Bertin Njinou Medico-Surgical Center of Urology and Mini Invasive Surgery Douala Cameroon National General Referal Hospital N’Djamena Chad Regional Hospital Limbe Cameroon General Hospital Yaounde Cameroon

Aim: Describe the clinical, radiological and management of patients with posterior urethral valves. Materials and Methods: This was a retrospective descriptive study over a period going from January 2011 to December 2016, reviewing 12 cases of patients treated for valves of the urethra posterior to the medical surgical center of urology in Cameroon at Douala. The variables studied were clinical, paraclinical, therapeutic and evolutionary. Results: In 5 years, we had diagnosed and treated 12 cases of posterior urethral valves, an average of 2.4 per year. The average age of patients was 41.6 months with extrems of 3 and 156 months. The reason for consultation was dominated by urinary tract infections. Urethrocystography and echography were performed in all patients and allowed to objectify a bilateral ureterohydronephrosis, a diverticular bladder in 9 cases and 4 cases of vesico-ureteral reflux, including a grade 4 according to the classification of Cendron, 8 patients suffered from acute urinary failure. Renal scintigraphyrealised on 3 patients had as objective in 1 patient the existence of a disfunctioning kidney. The treatment consisted of an endoscopic incision of the valves (n = 8), a vesicostomy (n = 3) and an iterative urethral dilatation with double J catheter placement (n = 1). The evolution was favorable (n = 7), and 5 cases of death were recorded. Conclusion: The endoscopic incision is the gold-standard of the treatment of the valves of the posterior urethra. The vesicostomy is an alternative in the absence of adequate technical platform. Despite adequate support, the prognosis remains burdened with significant mortality.

关键词： Valves of the Urethra Vesicostomy Endoscopic Incision Renal Failure

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Diagnosis and Management of Prostate Cancer in Urology

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Open Journal of Urology 2018年第5期8卷 161-165页

Introduction: Describe the diagnostic approach and management of prostate cancer at the medico-surgical center of urology in Douala, Cameroon. Materials and methods: This was a descriptive retrospective study reviewing 100 patient’s records suffering of prostate cancer from January 2011 to December 2015. The studied variables were clinical, paraclinical and therapeutic. Results: The mean age was 65 years with extrems of 50 and 85. Rectal examination was suggestive in 63 cases. 7 patients had a family history. The average PSA rate was 43.23 ng/ml. Histology has concluded to an adenocarcinoma in all patients. The gleason score was equal or greater than to 7 for 53 patients (53%). The extended assessment revealed distant metastasis for 43 patients. The treatment was: surveillance (n = 33), total laparoscopic radical prostatectomy (n = 24), surgical hormone therapy (n = 10), medical hormone therapy (n = 28) and chemotherapy coupled with hormone therapy (n = 5). Conclusion: Prostate cancer is common in Douala;its diagnosis is made late. Radical treatment is possible for localized cancers, hence the interest of early detection.

关键词： Prostate Cancer Adenocarcinoma Prostatectomy Hormone Therapy

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