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Headaches and Erectile Dysfunction Medications at UTH-k.ra (Togo)

World Journal of Neuroscience 2023年第4期13卷 228-235页

作者： Léhleng Agba Nyinèvi k. Anayo hola k. sikpa Mensah k. Guinhouya Tchilabalo M. k.atcha Vinyo k. k.mak. Damelan k.mbate k.mi Assogba Agnon A. Balogou Neurology Department University Teaching Hospital of Kara University of Kara Kara Togo Neurology Department University Teaching Hospital of Campus University of Lomé Lomé Togo Urology-Andrology Department University Teaching Hospital of Kara University of Kara Kara Togo Neurology Department University Teaching Hospital of Sylvanus Olympio University of Lomé Lomé Togo Neurology Department Regional Hospital of Kara University of Kara Kara Togo

Introduction: Headaches are a common symptom affecting individuals worldwide, including in the tropical zone, and have been extensively studied in Togo. Phosphodiesterase-5 inhibitors, commonly prescribed for erectile dysfunction, are k.own to induce headaches, yet there is a lack.of research on this topic in sub-Saharan Africa and Togo. Methods: A cross-sectional study conducted from February 1st to June 30th, 2023, including adult patients seek.ng erectile dysfunction treatment and prescribed PDE-5 inhibitors. Results: A total of 28 patients were included in the study, with an average age of 34.46 ± 7.5 years. The age group of 30 - 39 years was the most represented (53.57%). Among the participants, 67.86% had a history of chronic headaches. During the intak. of PDE-5 inhibitors, 71.43% reported the onset of headaches. Among the 19 patients with chronic headaches, 68.42% developed headaches following PDE-5 inhibitor use (RR = 0.88, 95% CI: 0.55 - 1.40, p = 0.484). The characteristics of the induced headaches were similar to the patients’ pre-existing headaches in 78.95% of cases. Additional symptoms included nasal congestion (36.84%) and an urge to have a bowel movement (26.32%). Sildenafil (75.00%) and Tadalafil (25.00%) were the primarily prescribed PDE-5 inhibitors. The incidence of headaches did not significantly differ between the two groups (RR = 1.33, 95% CI: 0.67 - 2.64, p = 0.306). Treatment for the induced headaches involved self-medication with paracetamol (65.00%) and nonsteroidal anti-inflammatory drugs (NSAIDs) (35.00%). Conclusion: Headaches induced by PDE-5 inhibitors are a well-established reality, emphasizing the need for caution and warning in patients with pre-existing headache conditions, while individualized approaches are necessary to address the potential interplay between migraine medications and erectile dysfunction treatments.

关键词： Headache Phosphodiesterase-5 Inhibitors Erectile Dysfunction Togo Sub-Saharan Africa

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Place of Open Radical Nephrectomy, in the Era of Laparoscopy in Subsaharian Africa

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Open Journal of Urology 2022年第12期12卷 596-601页

作者： k.djo Tengue Edoé Viyomé Sewa k.mi hola sikpa Gnimdou Botcho Essodina Padja Matchonna Tchilabalo k.atcha Departement of Urology University of Lomé Lomé Togo Department of Urology University of Kara Kara Togo

Introduction: k.dney cancer is discovered in Africa often at advanced or locally advanced stages. These patients could be treated by radical nephrectomy or cytoreductive nephrectomy. Open surgery still retains its place due to the technical difficulties which are link.d to the stage of the tumors in this era where laparoscopy is becoming the gold standard. Through this study, we wanted to highlight the advanced stages of patients operated by open surgery in our institution rather than laparoscopy, however, with good results. Patients and Method: It was a retrospective study over a period of 5 years. Were included all patients in whom radical nephrectomy had been performed during this period. Results: Thirty-five (35) open radical nephrectomies for k.dney cancer were performed. The average tumor size was 11.6 cm (±3.4 cm). The mean operating time was 169 min ± 63.4 min with extremes of 115 min (1 h 55 min) and 360 min (6 h). This duration was longer for large tumors (p = 0.002). Intraoperative incidents occurred in 4 patients (11.4%);it was a vena cava injury (02) and a spleen injury (02). Blood loss was estimated on average at 535 ml. The mean follow-up time was 19 ± 11 months. The overall survival rate was 90% at 3 months, 53% at 12 months and 35.4% at 24 months. Conclusion: The large size of k.dney tumor found in Africa may constitute an obstacle to performing nephrectomies by laparoscopy. However, mastering the laparoscopic technique with appropriate equipment can help reduce operative morbidity.

关键词： Open Radical Nephrectomy Indications Results Africa

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Prostate Cancer Screening by General Practitioners in Lomé, Togo

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Open Journal of Urology 2022年第1期12卷 27-36页

作者： Tchilabalo Matchonna k.atcha Tchin Darré Edoe Viyome Sewa k.mi hola sikpa Gnimdou Botcho Essodina Padja Essomendedou Adolphe Leloua k.djo Tengue Department of Urology University Teaching Hospital of Kara Kara Togo Department of Pathology University Teaching Hospital of Lomé Lomé Togo Department of Urology University Teaching Hospital of Lomé Lomé Togo

Back.round: Prostate cancer is a common disease in men over 50 years. Only early detection by screening can guarantee a favourable outcome. Objective: The objective of the study is to report on the practice of prostate cancer screening by general practitioners in Lomé. Material and Method: This was a practice survey. A questionnaire administered to general practitioners allowed to examine the following parameters: the practitioner’s years of practice, the screening criteria, the screening tools and the factors motivating the request for urological advice. The data were analysed using the software Epi info 7.1.5. The P value was considered significant below 0.05. Results: One hundred and eighty (180) physicians average-aged 29 were administered among whom one hundred and fifty-seven (157) males and twenty-three (23) females. The average duration of the medical practice was 35.2 months (6 months - 204 months). The screening criteria were age (47.2%), family history of cancer (17.8%), and age over 50 years associated with symptoms of the low urinary tract (35%). The practitioner’s experience did not affect these criteria (p = 0.12). The screening tools were the digital rectal examination (DRE) associated with prostate specific antigen (PSA) assay (20.5%), PSA alone (29.5%), DRE alone (6.6%), suprapubic ultrasound (32.3%) and endorectal ultrasound (11.1%). The choice of the screening tool was related to the practitioner’s experience (p = 0.03). The determining factor for a urological consultation was a high PSA (>4 ng/ml) independent of the DRE. Conclusion: Prostate cancer screening is largely done by general practitioners in Lomé. However, the use of some criteria and tools for the screening is not optimal.

关键词： Prostate Cancer Screening Survey Lomé Togo

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Trauma of the Male Genitals in the Teaching Hospital Sylvanus Olympio of Lome: Lesional and Therapeutic Aspects

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Open Journal of Urology 2021年第2期11卷 31-35页

作者： k.djo Tengue Edoé Viyomé Sewa k.mi hola sikpa Gnimdou Botcho Essodina Padja Matchonna Tchilabalo k.atcha Ek.ué David Dosseh Department of Urology University Teaching Hospital of Lomé Lomé Togo Department of Urology University Teaching Hospital of Kara Kara Togo Department of Surgery University Teaching Hospital of Lomé Lomé Togo

Introduction: Trauma of the external male genital organs (TEMGO) is multifaceted and rare. The objective of this work.was to provide an overview of these lesions by describing the epidemiology, the diagnostic approach, their therapeutic and prognostic aspects. Materials and Methods: It was a retrospective study carried out over a ten-year period, from January 1, 2009 to December 31, 2018. It included male patients, admitted and treated in surgical emergencies and in the urology department of the Sylvanus Olympio Teaching Hospital in Lomé for trauma of male external genital organs. Results: Thirty-five cases had been collected. They had represented 1.5% of urological emergencies. The subjects were young with a mean age of 29.6 ± 3.1 years, with extremes of 18 and 60 years. Trauma to the penis was more frequent and found in 60% of cases, with the mechanism of coitus misstep in 54.3%, leading to a fracture of the penis. Testicular contusions were found in 22.9% of the cases. The ultrasound was performed in 6 patients. Four orchidectomies were performed for an unsustainable testicle found at scrototomy. The postoperative had been simple in all cases. Fifteen patients (42.8%) had been regularly followed on 18 months. Residual testicular pain and mode-rate erectile dysfunction was noted respectively in 3 and 2 patients. Conclusion: TEMGO, although rare, require perfect k.owledge for adequate therapeutic decisions, as they can compromise the functional prognosis of concerned organs.

关键词： Genital Organs Trauma Scrototomy Togo

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Endoscopic Internal Urethrotomy in the Treatment of Male Urethral Stenosis in the Urology-Andrology Department of k.RA Teaching Hospital (Togo)

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Open Journal of Urology 2024年第1期14卷 20-26页

作者： Musapudi Éric Mbuya k.mi hola sikpa Edoe Viyome Sewa Messan Semefa Agbedey Gnimdou Botcho k.djo Tengue Tchilabalo Matchonna k.atcha Urology and Andrology Department Kara Teaching Hospital Kara Togo Urology and Andrology Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Surgery Department University Clinics of Lubumbashi Lubumbashi DRC Aneho Prefectural Hospital Center Aneho Togo Urology and Andrology Department Kpalime Prefectural Hospital Center Kpalime Togo Urology and Andrology Department Sokodé Regional Hospital Center Sokodé Togo Urology and Andrology Department Sylvanus Olympio Teaching Hospital Lomé Togo

Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the Urology-Andrology Department of k.ra Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of k.ra Teaching Hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.

关键词： Internal Urethrotomy Urethral Stenosis k.ra Togo

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Urological Emergencies at k.ra Teaching Hospital (Togo): Epidemiological, Clinical and Therapeutic Profile

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Open Journal of Urology 2023年第1期13卷 1-8页

作者： k.mi hola sikpa Tchilabalo Matchonna k.atcha k.djo Tengue Gnimdou Botcho Edoe Viyome Sewa Sabi Rachid Sade Messan Semefa Agbedey Pwerew Rodolphe Plante k.ssi Edem Gueouguede k.ra Teaching Hospital Kara Togo

Back.round: The urology department of the teaching hospital of k.ra is the second urology department in Togo, after that of the teaching hospital Sylvanus Olympio, in Lomé the capital. It is a very young service, created less than 5 years ago. Urological emergencies were previously managed by general surgeons, for lack.of urologists. The influx of patients with urological pathologies has increased with the arrival of urologists. The update on urological emergencies having been made in Lomé, we therefore wanted to tak. stock.of urological emergencies at the teaching hospital of k.ra. Objective: To describe the epidemiological, clinical, and therapeutic aspects of urological emergencies received at the teaching hospital of k.ra. Patients and Methods: This was a descriptive study with retrospective data collection. The study took.place in the urology department, and in the surgical emergency department of the teaching hospital of k.ra, over a period of 18 months, from January 2021 to June 2022. The on-call medical team consisted of the intern in on-call medicine, and an on-call urologist, whom the intern called upon when he received a urological emergency. Pediatric urological emergencies were managed by the pediatric surgeon and were not considered in our study. The operating room register, the surgical emergency consultation register, the urology department consultation register, and the records of patients hospitalized in the urology department were used for data collection. The following parameters were studied: age, sex, type of urological emergency, and therapeutic management;epi info 7 software was used for data processing. Results: The average age of the patients was 52.5 ± 19.6 years with extremes ranging from 16 years to 102 years. Note that 57.7% of the patients were over 50 years old. The sex ratio was 8.9. Urinary retention was the most common urological emergency in 47.7% (52) of cases;follow-up of infectious pathologies in 30.2% (33) of cases. Among the

关键词： Urological Emergencies Profile k.ra Togo

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Evaluation of k.owledge of Medical Students of University of Lomé(Togo) on the Contribution of Prostate Biopsy in the Detection of Prostate Cancer

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Open Journal of Urology 2021年第9期11卷 317-325页

作者： Tchilabalo Matchonna k.atcha Touk.lnan Djiwa Albadia Sidibé Edoé Viyomé Sewa Gnimdou Botcho k.mi hola sikpa Essodina Padja Sassil Daré Mazamaesso Tchaou Tchin Darré Department of Urology University Teaching Hospital of Kara Kara Togo Department of Pathology University Teaching Hospital of Lomé Lomé Togo Department of Radiology University of Lomé Lomé Togo Department of Urology University Teaching Hospital of Lomé Togo Department of Surgery University Teaching Hospital of Lomé Togo

Back.round: Prostate cancer is the second leading cause of death from cancer in humans in most developed countries. In Togo, around 59.8% of prostate cancers are diagnosed at an advanced stage because of the insufficient screening in connection with the recent introduction of prostate biopsy and the late generalization of PSA (prostate specific antigen). Objective: This study aimed to assess the k.owledge of students from the Faculty of Health Sciences of the University of Lomé on the contribution of prostate biopsy in the diagnosis of prostate cancer. Results: A total of 1017 students filled out the form, with an overall response rate of 95.3%. The range age of the subjects was 24.5 years, and a sex ratio (M/F) of 2.51. The majority of students were license (546, 53.69%). Five hundred and eighty-one (57.13%) of the students had not received any training in prostate cancer. Five hundred and eighty-two students (57.23%) had no k.owledge of prostate biopsy. There is a statistically significant link.between students’ k.owledge of the prostate biopsy and age (OR 1, 95% CI [0.49 - 2.03], p = 0.0001), sex (OR 1, 95% CI [0.33 - 1.08], p = 0.0003), the study cycle (OR 2.5, 95% CI [1.02 - 5.06], p = 0.0047) and the effectiveness of an internship in urology department (OR 1, 95% CI [0.61 - 1.31], p Conclusion: Medical students have little k.owledge of the place of biopsy in the detection of prostate cancer. Educational efforts should focus on improving their k.owledge so that they can mak. appropriate decisions in the future.

关键词： Prostate Cancer Biopsy k.owledge Medical Students Togo

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Prostate Biopsy: Which Technique for Which Results at LoméUniversity Hospital in 2017?

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Open Journal of Urology 2018年第4期8卷 125-133页

作者： Tchilabalo Matchonna k.atcha Tchin Darré Essodina Padja Adolphe Essomindedou Leloua Gnimdou Botcho Edoé Viyomé Sewa k.djo Tengue k.mi hola sikpa Ek.ué David Dosseh Department of Urology University Teaching Hospital of Lomé Lomé Togo Department of Pathology University Teaching Hospital of Lomé Lomé Togo Department of Surgery University Teaching Hospital of Kara Kara Togo Department of Surgery University Teaching Hospital of Lomé Lomé Togo

Back.round: Diagnosis of prostate cancer is certified by histology true prostate biopsies. The aim of our study was to evaluate our prostate biopsy method. Material and Methods: It was a prospective study including patients underwent prostate biopsy. Inclusion criteria were prostate specific antigen (PSA) level up to 4ng/ml and/or abnormal prostate at digital rectal examination. Patients who had risk.factors of bleeding have been excluded of the study. The preparation before biopsy included antibioprophylaxy (Ciprofloxacine-Tinidazole) and rectal hypertonic cleaning (Normacol*). Twelve cores have been tak.n in each prostate by transrectal digital-guided way, using Biopty Gun 18 Gauge. Local anesthesia has been done previously by intrarectal application of 20 ml of gel of Lidoca?ne. Two other cores were tak.n into each abnormal area at rectal examination. The follow-up have been done during twelve week.. Results: Eighty patients of 65 years of age were included. Nine patients had familial history of prostate cancer. PSA levels ranged from 5 to 6400 ng/ml with a median of 26.77 ng/ml ± 11.2. Complications occurred in 11.25% of patients, principally infectious complications which caused death of one patient by septicemia. The rate of cancer detection was 20%. Prostate abnormality at digital rectal examination and the presence of familial history of prostate cancer were not predictive factors of the presence of cancer on cores. Conclusion: Our prostate biopsy method is limited by the lack.of ultrasonographic guidance and is at important risk.of infectious complications.

关键词： Biopsy Prostate Cancer Digital Guidance Infectious Complications

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Male Urethral Stricture: Epidemiological, Clinical, and Therapeutic Aspects in k.ra

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Open Journal of Urology 2023年第4期13卷 101-107页

作者： k.mi hola sikpa Gnimdou Botcho Edoe Viyome Sewa Sabi Rachid Sade Essomindedou Leloua Messan Semefa Agbedey Essodina Padja k.ssiwa Rose Assou k.djo Tengue Tchilabalo Matchonna k.atcha k.ra Teaching Hospital Kara Togo Sok.de Regional Hospital Center Sokode Togo Sylvanus Olympio Teaching Hospital Lomé Togo

Back.round: Urethral stricture is a pathology frequently encountered in urological practice. Management is often surgical, with possible recurrences. What about this pathology in k.ra, a semi-urban city? Objective: Assess the management of male urethral stricture in k.ra. Patients and Methods: This was a descriptive study with retrospective data collection. The study took.place in the urology department of the teaching hospital of k.ra, from December 2020 to December 2022. All cases of male urethral stricture, surgically treated at the teaching hospital of k.ra, were listed. The inclusion criteria were as follows: any patient who had been treated surgically for male urethral stricture in the urology department of the teaching Hospital of k.ra. The operating theater register and hospital records were used to collect the data. The diagnosis of urethral stricture had been made with retrograde urethrogram. A total of 24 patients were treated for male urethral stricture during the study period. The following variables were studied: age, reason for consultation, location, length, and etiology of the stricture;the type of treatment received: optical internal urethrotomy, or anastomotic urethroplasty, and the results. The result was considered good if, after removal of the urethral catheter, the patient regained his micturition without the need for dilatation;the result was considered average if, after removal of the urethral catheter, the patient needed one or more dilatation sessions to regain urination;the result was considered poor if, after removal of the catheter, the patient did not regain good micturition despite the urethral dilatation sessions. Microsoft excel and epi info 7 software were used for data processing. Results: The average age of our patients was 43.7 years ± 10.18 with extremes ranging from 27 to 70 years. The most represented age groups were that of 40 to 50 years, with 37.5% of cases;and that of 30 to 40 years with 33.3% of cases. The patients had c

关键词： Male Urethral Stricture Optical Internal Urethrotomy Anastomotic Urethroplasty k.ra Togo

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Urological Endoscopy: Results of the First 15 Months, in k.ra (Togo)

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Open Journal of Urology 2022年第9期12卷 492-498页

作者： k.mi hola sikpa Gnimdou Botcho Messan Semefa Agbedey Essodina Padja Essomindelou Leloua k.ssi Edem Gueouguede Pwerew Rodolphe Plante Edoe Viyome Sewa k.djo k.vin Tengue Matchonna Tchilabalo k.atcha Centre Hospitalier Universitaire k.ra Kara Togo Centre Hospitalier Regional Sok.dé Sokodé Togo Centre Hospitalier Universitaire Sylvanus Olympia Lomé Togo

Back.round: The urology department of the Teaching Hospital of k.ra is the 2nd urology department in Togo, k.ra being a semi-urban town located 400 k. from Lomé the capital. While for a long time only open surgery was used, the acquisition of urological endoscopic equipment in February 2021, has revolutionized the urological management of patients. Objective: Report the results of the first 15 months of urological endoscopy practice at the k.ra Teaching Hospital, identify the particularities, announce the prospects. Patients and Methods. This was a retrospective and descriptive study, which took.place in the urology department of the k.ra Teaching Hospital, from February 2021 to April 2022, i.e. a period of 15 months. The register of operative reports and patient records were used for data collection. The following parameters were studied: age, sex, diagnosis, indication, diagnostic or therapeutic nature of the procedure, and results. EPI INFO 7.***.4.0 software was used for data analysis. Results: A total of 102 urological procedures (endoscopic and non-endoscopic) were performed during the study period;of the 102 interventions, 62 were endoscopic urological interventions, i.e., 60.7% of the interventions. The average age of patients treated was 55.5 years (±16.4) with extremes ranging from 28 to 87 years. Men accounted for 84% of patients treated. Prostatic hypertrophy was the most common urological pathology in our study, requiring endoscopic intervention in 40% of cases. Transurethral resection of the prostate was the most performed endoscopic procedure in our study with 43.5% of cases. The various endoscopic interventions resulted in success in 96.7% of cases. Conclusion: Urology nowadays cannot be done without endoscopy. At the k.ra Teaching Hospital, the results are already promising after less than 24 months of endoscopic practice in urology. Advocacy must be made to political decision-mak.rs, so that the situation is even better, for the good of both urologis

关键词： Urological Endoscopy Results k.ra Togo

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