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

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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Transurethral Resection of Bladder Tumours: Results and Outcomes

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Open Journal of Urology 2022年第6期12卷 342-356页

作者： Cyril Kamadjou Jerry Kuitche Annie Kameni Wadeu Achille Mbassi 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 Medical Technology Institute University of Yaoundé 1 Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at a urology center in Douala, Cameroon. Patients and Methods: This was a retrospective study carried out from 2015 to 2019 on 32 patients with bladder tumors that were managed at the Centre medico-chirugical d’urologie in Douala, Cameroon. The relevant data were obtained from patients’ clinical records. Results: A total of 32 patients (25 men and 7 women) aged 29 - 75 years were included in this study. The mean age of the study participants was 58.63 ± 11.00 years. Among our study participants, there were 10 smokers (31.25%). Eight (25%) of them had occupational exposure while 2 (6.25%) had residential exposure to bladder cancer. Thirty (93.75%) presented with hematuria, 2 (6.25%) presented with recurrent urinary tract infections, and 1 (3.13%) presented with acute urinary colic. Nineteen (59.38%) of them were anemic, with 4 (12.5%) requiring blood transfusions. Twenty-seven (84.38%) of them had pedunculated tumors while 5 (15.62%) had sessile tumors. The tumor diameters ranged from 1 cm to 5 cm, with a mean diameter of 2.75 ± 1.22 cm. Complete resection was performed in 27 (84.38%) participants while partial resection was performed in 5 (15.62%) patients. The early single instillation of intravesical chemotherapy with mitomycin was performed in 8 (25%) patients. Only one (3.13%) patient had a postoperative complication, and seven (21.88%) patients experienced tumor recurrence and underwent a second TURBT. Two (6.25%) of the 32 patients died and 30 (93.75%) survived. Conclusion: TURBT is the gold standard method of managing bladder tumors. This procedure is at the same time diagnostic and therapeutic for tumors that do not invade the walls of the urinary bladder.

关键词： Macroscopic Hematuria Bladder Tumor Transurethral Resection Mitomycin

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Prostate Cancer: Risk Factors and Outcome Indicators

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Surgical Science 2022年第8期13卷 381-400页

作者： Cyril Kamadjou Annie Kameni Wadeu Jerry Kuitche Achille Mbassi Justin Kamga fru angwafo Medico Surgical Center of Urology and Mini Invasive Surgery Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences Department of Surgery and Specialties University of Douala Douala Cameroon Yaoundé Medical and Technology Institute Yaoundé Cameroon Yaoundé General Hospital Yaoundé Cameroon Coordinator Urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background: Prostate cancer, which is the second most frequent cancer diagnosis made in men, more commonly occurs in the elderly. This disease is often diagnosed late in resource-limited settings, which results in people having advanced forms of the disease and a poor prognosis. This study aimed to identify factors indicative of prostate cancer aggressivity and a poor prognosis in patients with prostate cancer at a single center in Douala, Cameroon. Methods: We performed a retrospective study from 2015 to 2020 at the Centre medico-chirugical d’urologie in Douala, Cameroon, in which we included 203 patients aged 41 years to 85 years who had prostate cancer diagnosed via histopathology after either prostate biopsyor laparoscopic prostatectomy. Epi-info 7 was used for data analysis and logistic regression analyses were performed to identify factors associated with prostate cancer aggressivity and patients’ outcomes (survival or mortality). Results: The mean age of our study participants was 64.76 ± 7.48 years. Ten patients had a contributive family history of prostate cancer. The patients presented with lower urinary tract symptoms in 61.58% of cases. All patients had serum prostate-specific antigen (PSA) levels of >4 ng/ml, 100 patients were anemic, and 36 patients had aggressive forms of the disease. Eighty-eight patients had remarkable digital rectal examination (DRE) findings. The median prostate volume, as determined via transrectal ultrasonography (TRUS), was 59 [43 - 80] ml. Fifty-nine patients had abnormal prostate echostructures, and 33 patients died during follow-up. The presence of paraplegia and the practice of professions requiring unskilled labor were significantly associated with aggressive prostate cancer. The presence of lymphoedema, abnormal DRE findings, anemia, enlarged prostate glands (prostate volume >50 ml), and abnormal prostatic echostructures were significantly associated with both prostate cancer aggressivity and patients’ outcomes. Conclusio

关键词： Aggressive Prostate Cancer Early Diagnosis Transrectal Ultrasonography Prostate Biopsy Prognosis

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Transperitoneal Laparoscopic Nephrectomy for Non-Functional Kidneys: A Report of 25 Cases

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Surgical Science 2022年第10期13卷 460-470页

作者： Cyril Kamadjou Emmanuel Muhawenimana Innocent Nzeyimana Achille Mbassi Bertin Njinou Ngninkeu fru angwafo 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 Kigali University Teaching Hospital Kigali Rwanda Medical Technology Institute Yaounde Cameroon Gynaeco Obstetric and Pediatric Hospital Yaounde Cameroon

Background and Aim: Ever since the first-ever laparoscopic nephrectomy performed in 1991 by Clayman, laparoscopy has become the technique of choice for benign renal pathologies and also for cancerous lesions. In this paper, we present and evaluate the results of laparoscopic nephrectomy carried out on patients with non-functional kidneys at the Centre medico-chirugical d’urologie in Douala, Cameroon. Materials and Methods: This was a retrospective study carried out from 2016 to 2020. We included 25 patients with non-functional kidneys who underwent transperitoneal laparoscopic nephrectomy. Results: We included 25 patients (15 males and 10 females) with a mean age of 32.80 ± 9.76 years. Twenty (80%) patients presented with low back pain, four (16%) presented with acute pyelonephritis, and one (4%) presented with both low back pain and hematuria. The right kidney was damaged in 10 (40%) patients and the left kidney in 15 (60%) patients. The kidney failure requiring nephrectomy was due to stones in 16 (64%) patients and upper pyeloureteric junction obstruction in nine (36%) patients. The mean surgery duration was 111.08 ± 31.95 minutes. The median perioperative blood loss was 100 [70 - 120] ml. Percutaneous drainage was required in 13 (52%) patients. Only two (8%) patients developed postoperative complications. The mean follow-up duration was 64 ± 24.48 days. All patients survived the surgical intervention. Conclusion: Laparoscopic nephrectomy is a mini-invasive technique that is suitable for the surgical removal of non-functional kidneys due to either ureteropelvic junction obstruction or massive kidney stones.

关键词： Pelvic Calculi Laparoscopy Nephrectomy Pyeloureteric Junction Obstruction

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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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Correlation between the International Prostate Symptom Score, Ultrasound Features and Maximum Flow Rate in Cameroonian Patients with Benign Prostatic Hypertrophy

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Open Journal of Urology 2022年第1期12卷 37-50页

作者： Landry Oriole Mbouché Achille Aurèle Mbassi Frantz Guy Epoupa Ngallè Forbang Ako Axel Stéphane Nwaha Makon Boniface Moifo fru angwafo III Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences Yaoundé Cameroon Yaoundé Gyneco-Obstetric and Pediatric Hospital Yaoundé Cameroon Department of Surgery Higher Institute of Medical Technology Yaoundé Cameroon Department of Radiology and Medical Imaging Faculty of Medicine and Biomedical Sciences Yaoundé Cameroon

Background: Benign prostatic hypertrophy is the non-malignant stromal and epithelial proliferation of the prostate gland, with or without associated anatomical enlargement of the gland and clinical symptoms. Symptomatic Benign prostatic hypertrophy may cause obstructive symptoms, irritative symptoms or both obstructive symptoms include a sensation of incomplete bladder emptying, straining to void, urinary hesitancy and weak stream while irritative symptoms include dysuria, nocturia, urinary frequency and urinary urgency. A quantitative measure of the severity of lower urinary tract symptoms due to benign prostatic hypertrophy can be obtained using the International Prostate Symptoms Score. Ultrasonography is useful for helping to determine bladder and prostate size in patients with urinary lower urinary tract symptoms. Uroflowmetry is a non-invasive test that assesses voiding function. It provides valuable data on the voided volume, time is taken to reach maximum flow rate and average flow rate. The goal of this study was to improve the follow up of patients with benign prostatic hypertrophy by providing simple, available, affordable and non-invasive that best predict bladder outlet obstruction and the quality of life in these patients. Method: This was a cross-sectional analytic study carried out over a period of five months from May 2020 to September 2020 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital, which is a tertiary hospital in Cameroon. Were included in the study, adult males who presented with lower urinary tract symptoms and prostatic enlargement suggestive of benign prostatic hypertrophy taking into account clinical, uroflowmetry and ultrasound findings. Results: A study population of 103 participants was recruited. The mean age of patients was 63.17 ± 10.26 years. Concerning the International Prostate Symptoms Score, the mean total, voiding (obstructive) and storage (irritative) scores were 14

关键词： Benign Prostate Hypertrophy Intravesical Prostatic Protrusion Acute Urinary Retention

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Nephrectomy in a Patient with Medullary Sponge Kidney Associated with Severe Nephrocalcinosis and Nephrolithiasis: A Rare Condition

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Open Journal of Urology 2021年第9期11卷 332-341页

作者： Landry Oriole Mbouché Achille Aurèle Mbassi Junior Mekeme Mekeme Axel Stéphane Nwaha Makon Pierre Joseph Fouda fru Fobuzshi angwafo III Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences Yaoundé Cameroon Department of Uro-Andrology Yaoundé Central Hospital Yaoundé Cameroon Department of Surgery Higher Institute of Medical Technology Yaoundé Cameroon

Background: Medullary sponge kidney (MSK) is a disturbance of renal development characterized by cystic dilation and diffuse precalyceal duct ectasia. The disease affects both genders in equal proportions and is generally diagnosed in adulthood, as a result of recurrent calcium nephrolithiasis and nephrocalcinosis. The most frequently encountered manifestations being renal colic, microscopic or macroscopic hematuria, and fever. The intravenous pyelogram is standard for diagnosis and metabolic workup is required to identify the underlying cause. The main goal of treatment is to prevent recurrence and disease progression. Though considered a benign condition, a nephrectomy may often be required in patients presenting late with irreversible complications and end-stage renal disease. Aim: To highlight and discuss the presentation and management of a rare case of nephrocalcinosis and nephrolithiasis secondary to the medullary sponge kidney. Case presentation: We report herein the case of a 56-year-old male with long-standing hematuria in whom a diagnosis of medullary sponge kidney disease was made and he underwent a left total nephrectomy. The postoperative course was uneventful. Conclusion: Nephrocalcinosis and nephrolithiasis are complications of MSK and can result in irreversible renal damage. A high index of suspicion is necessary for patients presenting with renal colic, recurrent urinary tract infections, or hematuria for prompt diagnosis and management.

关键词： Medullary Sponge Kidney Nephrolithiasis Nephrocalcinosis Nephrectomy

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Evaluation of the Quality of Micturition in Patients Who Underwent Anastomotic Urethroplasty at the Yaounde Central Hospital, Cameroon

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Open Journal of Urology 2024年第2期14卷 115-127页

作者： Achille Aurele Mbassi Landry Oriole Mbouche Junior Mekeme Mekeme Jean Crepin Eloundou Nkolo Bright Che Awondo Jean Cedrik Fouda Frantz Guy Epoupa Ngalle Cyril Kamadjou Pamela Anaba Laure Pierre Joseph Fouda fru Forbuzshi III angwafo Higher Institute of Medical Technology Yaounde Cameroon Higher Institute of Health Sciences Bangangte Cameroon Urology and Andrology Department Yaounde Central Hospital Yaounde Cameroon Department of Surgery and Subspecialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Yaounde Gynecology Obstetrics and Pediatric Hospital Yaounde Cameroon

Introduction: Radiological investigation which is the gold standard to perform following anastomotic urethroplasty in order to evaluate the quality of micturition is costly. In our context, due to financial limitations, reconstructive urologists prefer to use the uroflowmetry in order to assess the micturition post-surgery. Therefore, the objective of the study was to assess the quality of micturition using the uroflowmetry after anastomotic urethroplasty. Methodology: We conducted an 11-year retrospective review (1st January 2006-31st December 2017) and a cross-sectional descriptive observational study for a period of 8 months (November 2017-June 2018) at the Urology and Andrology Department of the Yaounde Central Hospital (YCH) of patients who were diagnosed with urethral stenosis and underwent an anastomotic urethroplasty at the YCH. We excluded patients who had incomplete files, patients lost to follow-up and did not do pre-operative uroflowmetry. Quality of micturition was evaluated using a uroflowmetry. Data was analyzed using EPI info 7.0. Parametric variables were reported as means and standard deviations and percentages and counts were used to report categorical variables. Results: We had a sample of 60 patients. The mean age was 42 ± 5 years with extremes ranging from 20 to 76 years. Twenty-seven (27) patients, or 45%, had no post-operative complications, and those who did had a urinary tract infection (26.70%). In our series, we had 82% excellent results (patient satisfied with his urination with bell-shaped urinary stream and urinary flow greater than or equal to 15 ml/sec);15% good results (patient with moderate dysuria with average urinary stream and urinary flow between 10 and 14.9 ml/sec) and 3% poor results (severe dysuria with urinary flow less than 10 ml/sec, urinary retention or urinary incontinence). Based on these results we can say that the success rate in our series was 97%. 96.70% of patients were satisfied against 3.3%

关键词： Urethra Stricture Anastomotic Urethroplasty

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Birth Injuries in Neonates at a University Teaching Hospital in Cameroon: Epidemiological, Clinical and Therapeutic Aspects

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Open Journal of Pediatrics 2017年第1期7卷 51-58页

作者： E. M. Mah P. Foumane D. H. Ngwanou S. Nguefack A. Chiabi J. S. Dobit H. Siyou J. B. Bogne E. Mbonda fru angwafo III Yaounde Gyneco-Obstetric and Pediatric Hospital Yaounde Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Background: Statistics on birth injuries in Cameroon are scarce, despite its frequency in postnatal consultations;we sort to find its prevalence and contributing factors, the different clinical presentations and treatment methods. Methodology: This was a retrospective, descriptive study. Data on maternal characteristics, neonatal factors, the place of birth and qualification of birth attendant, age at diagnosis, clinical presentation and management were considered. Results: Among the 14,284 newborns that were consulted from January 2003 to February 2014, 263 (1.84%) had birth injuries. The average age at diagnosis was 12 days. The contributing factors were: advanced maternal age, macrosomia, vaginal and instrumental delivery. Birth attendants were mostly nurses and the health center was the place of birth for 57.4% of patients. The main clinical presentations were: obstetric brachial plexus palsy (70.6%), fracture of the clavicle (22.5%) and fracture of the humerus (4.80%). Physiotherapy and orthopedic treatment were methods used with favorable outcome. Conclusion: The frequency of birth injury is relatively high in our context. The diagnosis is late, birth attendants need to be trained and systematic examination of all newborns in delivery room encouraged.

关键词： Birth Injury Newborn Yaoundé

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Clinical Presentation, Therapeutic Aspects and Results of Urogental Prolapse in Yaounde

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Open Journal of Urology 2024年第2期14卷 83-94页

作者： Junior Barthelemy Mekeme Mekeme Pierre Joseph Fouda Marie Josiane Ntsama Essomba Jean Cedric Fouda Marie Salome Eko’o Neme Marcel Junior Yon Mekeme Achille Y. Kpanou Bright Che Awondo Philip Fernandez Owon’Abessolo Marcella Biyouma Achille Aurele Mbassi Robinson Mbu Robinson fru angwafo III Department of Urology and Andrology Yaounde Central Hospital Yaounde Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department of Surgery Yaounde University Teaching Hospital Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences Douala Douala Cameroon Department of Urology and Andrology Laquintini Hospital Douala Douala Cameroon Department of Obstetrics and Gynaecology Yaounde Obstetrics Gynaecology and Pediatrics Hospital Yaounde Cameroon

Introduction: Urogenital prolapse is the descent of one or more elements of the abdominal-pelvic contents into the vaginal cavity. The anterior, middle and posterior anatomical compartments may be involved giving rise to several types of genital prolapse. However, there are various therapeutic modalities ranging from observational procedures to surgery. In Yaounde, urogenital prolapse appears to be a rare clinical entity, and its treatment has not been clearly stated. There is limited data about this subject in our context. Our aim was to study the clinical and therapeutic aspects of urogenital prolapse in Yaounde. Methods: We conducted a descriptive cross-sectional study with retrospective data collection at the Yaounde Gynaecological Obstetric and Pediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH) over a period of 05 months (from February 2022 to June 2022). All women aged ≥30 years and all women with documented urogenital prolapse admitted to the maternity and urology departments of these two health facilities were included. Data were collected using a structured questionnaire. Data was analyzed using IBM SPSS (statistical package for social sciences) software version 23.0 and the data were reported as mean, standard deviation, frequencies and percentages. Results: A total of 50 patients were recruited;the mean age was 45.8 ± 17 years. The age range was from 21 to 72 years. Majority of the patients were aged more than 55 years (32%). Most of the patients attended primary education (48%). Forty percent of the patients were housewives. The majority of the patients were from West Cameroon (26%). The most common reason for consultation was pelvic heaviness (54%). The most prevalent clinical sign was cystocele (56%), followed by hysterocele (54%). According to the Baden Walker classification, one-third of the patients were classified as first degree (36%). More than half (58%) of patients had the condition located at the first stage. Surgery was perform

关键词： Urogenital Prolapse Cystocele Hysterocele Clinical Surgery

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