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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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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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Hormone-Naïve Metastatic Prostate Cancer: A Presentation of 110 Cases in a Urology Center in the City of Douala, Cameroon

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Open Journal of Urology 2022年第1期12卷 83-97页

作者： Cyril Kamadjou Calson Ambomatei Landry Mbouche Zacharie Sando Achille Mbassi fru angwafor Medical Surgical Center of Urology and Minimal Invasive Surgery Douala Cameroon Department of Surgery and Specialities Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Health Search Association Douala Cameroon Gyneco-Obstetric and Pediatric Hospital Yaounde Cameroon Urology Service Central Hospital Yaounde Cameroon

Aim: According to World Health Organization, prostate cancer is one of the increasing malignancies in men worldwide. This paper aims to describe the epidemiological, clinical, diagnostic, therapeutic, and evolutionary aspects of patients with early metastatic prostate cancer in a urology center in the city of Douala in Cameroon. Materials and Methods: It is a retrospective and descriptive study of 110 patients with prostate cancer that was immediately metastatic at diagnosis over a period of six years (from January 2014 to December 2020). Results: The average age of patients at diagnosis was 67.5 years (range: 45 years to 88 years) and 53.63% of patients had body mass indexes greater than 25. Disorders of the lower urinary tract were the main presenting complaint in 55.45% of cases, followed by bone and joint pain in 46.36% of cases. Digital rectal examination was suggestive of prostate cancer in 96.36% of cases with an average total prostatic specific antigen (PSAT) level of 676.9 ng/ml (range: 21.8 to 8832 ng/ml). The diagnosis was made through prostate biopsy in 57 (51.81%) patients or after palliative endoscopic resection of the prostate indicated for lower urinary tract symptoms or even acute urinary retention in 53 (48.18%) patients. Adenocarcinoma of the prostate was the main histologic type, and in 47.27% of cases, the tumor was poorly differentiated with a Gleason’s score of greater than 7. The sites of metastasis were mainly the lymph node (87.27%), bone (56.36%), and both (44.54%). The treatment was palliative and dominated by bilateral pulpectomy in 60% of cases and luteinizing hormone-releasing hormone agonists (Triptorelin 11.25 mg every 3 months) in 44 (40%) of cases. Conclusion: Prostate cancer is a real public health problem in developed countries but also in Africa, especially in Cameroon. It is aggressive cancer that is often diagnosed when metastasis has already occurred. Its man

关键词： Prostate Cancer Metastasis Hormone Therapy Palliative Treatment

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Laparoscopic Pyelolithotomy: Initial Experience with 62 Patients

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Open Journal of Urology 2022年第1期12卷 74-82页

作者： Cyril Kamadjou Annie Kameni Dolly Bilonda Kolela Bertin Njinou Ngninkeu 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 Coordinator Urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon

Objective: To evaluate the role of the laparoscopic approach in the management of pelvic calculi in a urology centre in Douala, Cameroon. Materials and Methods: This was a retrospective study carried out from 2014 to 2019 involving 62 patients with calculi at the renal pelvis managed through laparoscopic pyelolithotomy. Results: We recruited 62 patients (38 men and 24 women) with a median age of 36 [25 - 48] years. Nephritic colic was the most frequently encountered presenting complaint (92% of cases). In 56.45% of cases, the stone was on the left side of the body. Twelve patients had kidney acute failure at the time of diagnosis. Five patients received antibiotics for urinary tract infections before the operation. Before surgery, eight double J stents were placed in 8 patients;in five because of urinary tract infection and in three because of nephritic colic. In all the cases, the definitive diagnosis was made using abdominal CT scans. The median size of the calculi was 22 [17 - 28] mm. Dilatation of the pyelocaliceal cavity was noticed in all the patients. The median surgery duration was 100 [90 - 120] minutes. Drainage of the urinary tract using a double J stent was performed in all the patients, whereas percutaneous drainage was performed only in 9.67% of cases. There was no case of conversion to open surgery. Control ultrasound performed one month after the removal of the double J stent did not reveal any residual stones in the pyelocaliceal cavities. Conclusion: Laparoscopic pyelolithotomy is a mini-invasive technique that is adequate for the management of voluminous pelvic calculi.

关键词： Laparoscopic Pyelolithotomy Pelvic Calculi Cameroon

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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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Endoscopic Management of Bladder Stones: Initial Experience at a Single Center in Cameroon

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Open Journal of Urology 2022年第5期12卷 276-285页

作者： Cyril Kamadjou Annie Kameni Herve Moby Dolly Bilonda Kolela Achille Mbassi fru angwafor Medico-Surgical Center of Urology and Mini-Invasive Surgery Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Medical and Technology Institute Yaoundé Cameroon Coordinator of the Urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Purpose: This study aimed to evaluate the efficacy and safety of endoscopic lithotripsy with the lithoclast (EMS, Switzerland) and laser Holmium YAG in the management of bladder calculi. Materials and methods: This was a retrospective study carried out from January 2013 to December 2019 on 32 patients with bladder calculi. All the patients underwent either Lithoclast or Laser lithotripsy using a 22F Storz cystoscope at the Centre medico-chirugicale d’urologie in Douala, Cameroon. Data on patients’ ages, clinical symptoms, stone sizes, type of lithotripsy, surgery duration, and results of lithotripsy were collected and analyzed using Epi info 7. Results: We recruited 32 participants (24 men and 8 women) with a median age of 41.28 [22 - 68] years into this study. In 9 (28.12%) participants, macroscopic hematuria was the main presenting complaint, followed by lower urinary tract symptoms in 8 (25%) patients. A cystoscopy was performed in 17 (53.12%) patients to confirm the diagnosis of a bladder stone, and ultrasonography of the upper urinary tract was performed in 29 (90.6%) cases to certify the absence of another stone. Lithoclast EMS was used to manage the stones in 23 (71.87%) patients while laser lithotripsy was used in 9 (28.13%). A dormia basket was used to remove stone fragments in 10 (31.25%) patients. The mean surgery duration was 33.59 ± 14.2 minutes, and the bladder stones were successfully managed in all the participants of this study. Minor complications such as pain during micturition were found in 28 (87.37%) patients, with complete resolution occurring two weeks after surgery. Conclusion: Endoscopy with lithotripsy is a safe and effective method of management of bladder stones. This technique is also associated with short surgical procedures and postoperative hospitalization periods. We believe that it is an excellent treatment modality in the management of bladder stones.

关键词： Bladder Stone Lithotripsy Mini-Invasive Surgery Dormia Basket

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Evaluation of Extracorporeal Shockwave Lithotripsy in the Management of Renal and Ureteral Calculi

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Open Journal of Urology 2021年第12期11卷 474-485页

作者： Cyril Kamadjou Calson Ambomatei Achille Mbassi Annie Kameni Dolly Bilonda Kolela fru angwafor Medical and Surgical Center of Urology Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences Department of Surgery and Specialities University of Douala Douala Cameroon Elisabeth Glaser Pediatric AIDS Foundation Buea Cameroon Central Hospital Yaounde Cameroon Coordinator Urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon

Aim: To evaluate the efficacy of extracorporeal lithotripsy in the management of renal and ureteric calculi in a urology center in Douala, Cameroon. Materials and Methods: This is a retrospective study carried out over six years, between January 2014 and December 2020. All the patients were treated using a Direx Integra lithotripter, with the number of shockwaves ranging from 1200 to 3500, without anaesthesia and were discharged a few hours after the procedure on the same day. In a majority (63.75%) of the cases, the calculi were incidental findings. A Double-J stent was indicated in two patients and preceded extracorporeal lithotripsy because of renal colic and signs of urinary tract infection. Results: We recruited a total of 122 patients with a mean age of 42.19 ± 13.08. We had 65 (53.3%) males and all patients had at least one calculus confirmed by CT scan with a mean size of 13.84 ± 4.17 mm, 85 (69.7%) patients became completely stone-free after a maximum of four sessions of extracorporeal lithotripsy (ESWL). 21 (17.2%) patients had intermediate results, being asymptomatic and/or having less than three residual fragments that measured less than 4 mm. The failure rate was 13.9%, with 17 patients still having more than three fragments measuring more than 4 mm after 4 ESWL sessions. 1 (0.8%) had septic shock as a post ESWL complication while 6 (4.9%) benefitted from a complimentary medical and/or surgical treatment (double J stent placement). Conclusion: The management of renal and ureteral calculi through extracorporeal lithotripsy in adults seems to be particularly effective for renal calculi measuring less than 20 mm and ureteral calculi measuring less than 15 mm. Extracorporeal lithotripsy, which can be performed on an outpatient basis (and without anaesthesia) is associated with minimal complications, and remains the option of choice for most upper urinary tract calculi.

关键词： Renal and Ureteric Calculi Extracorporeal Lithotripsy Double-J Stent

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Transperitoneal Laparoscopic Ureterotomy: A Mini-Invasive Option for Ureteral Stones

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Surgical Science 2022年第3期13卷 135-143页

作者： Cyril Kamadjou Herve Edouard Moby Annie Kameni Wadeu Achille Mbassi Bertin Njinou Ngninkeu fru angwafor Medical and Surgical Center of Urology Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences Department of Surgery and Specialities University of Douala Douala Cameroon Higher Medical and Technology Institute University of Douala Douala Cameroon Coordinator Urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon

Background and Objective: Laparoscopy can be an alternative modality in the management of ureteral stones. We herein present our experience with laparoscopic ureterolithotomy although most ureteral stones are managed using endourologic techniques, open surgery, or shockwave lithotripsy. Materials and Methods: This retrospective study was performed from January 2014 to December 2019 on 20 patients with ureteral stones who were treated using transperitoneal laparoscopic access. We collected data on patients’ ages, genders, clinical profiles, relevant medical history, sizes of the calculi, localisation of the calculi as confirmed by imaging, and outcome of lithotripsy. Continuous data were presented as mean values and standard deviations (for normally distributed data) and medians with interquartile ranges (for skewed data). Categorical data were presented as frequencies and percentages. Results: We included 20 patients (13 males and 7 females) with a mean age of 40.40 ± 13.25 years. The mean stone size was 18.5 ± 3.05 mm and all procedures were completed laparoscopically. The mean operative time was 96 ± 22.34 minutes. The mean estimated blood loss was less than 150 ml, and none of the patients received a blood transfusion. There was no intraoperative complication or postoperative complications, except for leakage of urine in the suture area. The mean hospital stay was 2.05 ± 0.69 days and the double J stent was removed after an average of 20 days post-operatively. The stone-free rate was 100% and after a mean follow-up period of 3 months, there was no stone recurrence. Conclusion: Laparoscopic ureterolithotomy is an effective and safe technique in the management of ureteric stones. The benefits of this technique include minimal postoperative morbidity, short postoperative hospitalization, a short convalescence period, and remarkable cosmetic results.

关键词： Ureteral Calculi Laparoscopy Cosmetic Results

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Mucinous Carcinoma of the Scrotum about a Case in Yaounde

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Open Journal of Urology 2023年第6期13卷 173-177页

作者： Boris Amougou Fred Dikongue Dikongue Divine Eyongeta Thierno Mamadou Oury Diallo David Douglas Banga Nkomo Demba Cisse Arlette Dongmo Alice Ghislaine Ndoumba Afouba Joseph Fondop Theodore Sala Beyeme Faustin Atemkeng Yaya Sow Abdoulaye Bobo Diallo fru angwafor Department of Surgery and Surgical Specialties Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Department of Surgery and Surgical Specialties Faculty of Health Sciences of Buéa University Buéa Cameroon Faculty of Medicine and Pharmacy Gamal Abdel Nasser University Conakry Guinea Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery and Surgical Specialties Faculty of Health Sciences of Gaston Berger University Saint-Louis Senegal Department of Surgery Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in the management of urogenital cancers in developing countries. Case presentation: This was a 62-year-old patient who had consulted for fistulized lesions of the scrotum associated with urinary disorders. Physical examination found budding lesions in the scrotum from which mucus was leaking. The diagnostic assessment carried out consisted of a biopsy sample of the scrotal lesions, a blood analysis and medical imaging, which led to the diagnosis. The mutilating nature of the surgery proposed to the patient after multidisciplinary consultation meeting and the expensive cost of chemotherapy drugs constituted the limits of the patient’s therapeutic management. Conclusion: Mucinous carcinoma of the scrotum is rare and primary lesion should always be sought. The presence of budding lesions of the scrotum with discharge of mucus should suggest the diagnosis.

关键词： Scrotal Cancer Mucinous Carcinoma Scrotal Fistulas

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Germination and Survival of Maize and Beans Seeds: Effects of Irrigation with NaCl and Heavy Metals Contaminated Water

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Open Journal of Applied Sciences 2022年第5期12卷 769-792页

作者： Cornelius Tsamo Sendze Martinien Alanyuy Eric fru Zama Chi Christopher Tamu Department of Agricultural and Environmental Engineering College of Technology University of Bamenda Bambili Cameroon Department of Chemistry Higher Teachers’ Training College University of Maroua Maroua Cameroon

Metal toxicity and soil salinity at excessive levels in soils are toxic to plants. The main objective of this study was to demonstrate the effects of water salinity (NaCl) and heavy metal concentration on germination and seedling characteristics of maize and beans seeds. Different concentrations of NaCl (0 to 35000 mg/L) and Zn2+, Cu2+ and Pb2+ with concentrations 0 to 600 μmol/L each were used separately. These solutions were used to irrigate maize and bean seeds for 30 days. Data was taken daily for the following parameters;“the number of germinated seeds, shoot length, shoot circumference, leaf area index, leaf colors, senescence, and disease occurrences.” The crops were uprooted at the end of the 30 days and their wet masses were measured and recorded. Results indicated that seed germination reduced with an increase in the concentration of NaCl for both maize and beans with 0% germination recorded in concentrations > 5000 mg/L. The same trends were observed for other parameters, the shoot length, the leaf area index, and the shoot circumference. “For heavy metals, the trends were similar. Beans growth was more affected by Zn and Cu but maize growth was more affected by Pb.” The dry masses and wet masses of the crops with higher concentrations of metals and salts were very low compared to the control experiments. For the effects of salinity and heavy metals on beans and maize seeds, there was a significant difference (P ≤ 0.001) between all tested concentrations and the control for all growth parameters monitored. It was concluded from the results that salinity and heavy metals affect the germination and seedling characteristics of maize and beans;though some metals are essential, their presence in higher concentrations instead cause harm.

关键词： Salinity Heavy Metals Pollution Seedling Characteristics Irrigation

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