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Management of Priapism in Sickle Cell Patients: Experience of the Urology Department of the University Hospital Centre of Libreville

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Open Journal of Urology 2021年第3期11卷 87-94页

作者： Adiren Mougougou Steevy Ndang Ngou Milama jean Félix Ngomas Natacha Boumas Francine Chimelle Mbana Boukoulou Dimitri Mbethe Izoudine Bissiriou jean massande mouyendi Urology Department University Hospital Center of Libreville Libreville Gabon Emergency and Anaesthesia Department University Hospital Center of Libreville Libreville Gabon Paediatric Surgery Department University Hospital Centre—Mother and Child—Jeanne Ebori Foundation Libreville Gabon

Introduction: Priapism is a rare pathology, known since antiquity. Sickle cell disease is the main aetiology in Africa. The aim of our work was to report our experience in its treatment. Material and Methods: This is a prospective, descriptive study carried out at the urology department of the Libreville University Hospital from January 2018 to December 2020. All sickle cell patients admitted to urology for priapism were included. The parameters studied were socio-demographic, clinical and therapeutic parameters as well as the evolution after treatment. Result: We collected 19 priapisms in sickle cell patients. The average age was 20.9 years with extremes of 4 and 53 years. Fifteen patients were homozygous SS. All patients had stasis priapism. The average consultation time was 22.4 hours. All patients had perioperative medical management combining hyperhydration, analgesia and antibiotic prophylaxis. A vasoactive drug was administered to 13 patients. Sixteen patients had a puncture of the corpus cavernosum. A distal cavernosal-spongiosum shunt under penile block was performed in 6 patients. The outcome was favorable from the outset in 12 cases, marked by complete detumescence of the corpus cavernosum. Partial detumescence was noted in 7 patients with the need for a new puncture of the cavernous body. A complication such as edema of the penis was in only one of our patients. A recurrence was noted in 2 patients. After an average follow-up of 6 months, no sequelae erectile dysfunction was observed. Conclusion: Priapism is a frequent complication among sickle cell patients in Libreville. Medical management associated with a cavernous puncture with administration of vasoactive drugs allows a favourable evolution without after-effects.

关键词： Priapism Sickle Cell Disease Vasoactive Drug Cavernous Puncture Libreville

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Prostatic Burkitt Lymphoma, a Rare Secondary Location

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Open Journal of Urology 2021年第6期11卷 226-231页

作者： Adrien Mougougou Steevy Ndang Ngou Milama Smith Giscard Olagui jean Massandé mouyendi Urology Department University Hospital Center of Libreville Libreville Gabon General Surgery and Urology Department Instructions Hospital of the Armies Omar Bongo Ondimba Libreville Gabon

Introduction: Non-Hodgkin’s malignant lymphoma is found primarily in African children. Prostate localization is a rare entity. We report the case of a secondary prostatic localization of Burkitt lymphoma in a 14-year-old child. Observation: the 14-year-old child NNJ was followed at the Libreville Cancer Institute (ICL) for Burkitt maxillo-facial stage II bilateral Murphy lymphoma. The clinical examination noted an alteration of the general state, total hematuria, a voluminous prostatic mass filling the rectal ampoule. The paraclinical assessment noted renal insufficiency, a prostatic mass on ultrasound. Anatomo-pathological examination of the prostatic biopsy diagnosed Burkitt type non-Hodgkin’s malignant lymphoma. He died a week later. Conclusion: Primary or secondary prostatic lymphoma is rare. Obstructive renal insufficiency is an additional complication that darkens its prognosis by delaying etiological treatment based on polychemotherapy.

关键词： Burkitt Lymphoma Prostate Renal Insufficiency Libreville

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Are There Prognostic Factors for Failure of Surgical Treatment of Post-Traumatic Posterior Ureteral Stenosis? About 30 Cases and Review of the Literature

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Open Journal of Urology 2022年第10期12卷 539-548页

作者： Dimitri Mbethe Mohammed Said Moudouni Adrien Mougougou Steevy Ndang Ngou Milama Izoudine Bissiriou Bilal Smith Olagui jean Massandé mouyendi Urology Department the University Hospital of Libreville Libreville Gabon Urology Department the Mohamed 6 University Hospital of Marrakech Marrakech Marocco Urological and Visceral Surgery Department Hospital of Instruction of the Armies Omar Bongo Ondimba Libreville Gabon

Introduction: The management of post-traumatic stenosis of the posterior urethra is divided between early endoscopic realignment and delayed surgery. In the latter case, several techniques are used taking into account several factors. Our objective was therefore to investigate the possible prognostic factors of failure of this surgical management. Material and Methods: We conducted a retrospective study from January 2006 to December 2017 on patients admitted to the Urology Department of the Mohammed 6 University Hospital of Marrakech for management of post-traumatic posterior urethral stenosis. The parameters studied were age, medical and surgical history, causes, characteristics of the stenosis (location, number, length), associated lesions, surgical technique used, and evolution. The descriptive analysis consisted of calculation of absolute and relative frequencies for the qualitative variables, and of position and dispersion parameters for the quantitative variables (mean, standard deviation). In bivariate analysis, the comparison of categorical variables used Pearson’s Chi-square statistical test and Fisher’s test if necessary. The significance threshold was set at p Results: A total of 30 cases were selected. The age of our patients varied between 18 and 68 years, with an average of 38.33 years (16 - 80 years);the most affected age group was between 20 and 39 years. The mode of revelation of urethral damage was dominated by acute retention of urine present in 76% of patients, followed by dysuria (33%). The stenosis extended over 21.91 mm on average (14 - 40 mm). It was accompanied by bone involvement in 15 patients (53.3%). Erectile dysfunction was present in 23 patients (23%). Terminal urethrogram was the main surgical technique used, followed by internal urethrotomy (60% and 30% respectively). 15 patients had a recurrence, with an average of 1-second operation. Statistical analysis of the different factors studied showed no correlation with the occurrence of

关键词： Posterior Urethra Stenosis Urethrogram Endoscopic Realignment

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Sexual Functional Prognosis of Penile Emergencies at the University Hospital of Libreville

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Open Journal of Urology 2022年第10期12卷 527-538页

作者： Adrien Mougougou Steevy Ndang Ngou Milama Smith Giscard Olagui Dimitri Mbethe Grace Cherile Ongouta Alice Armande Boutsomba Moukinda jean Massandé mouyendi Urology Department UHC of Libreville Libreville Gabon Department of Surgery and Surgical Specialties University of Health Sciences Owendo Gabon Department of General and Urological Surgery Omar Bongo Ondimba Army Training Hospital Libreville Gabon

Introduction: Penile emergencies are multiple and varied, and they can jeopardize the sexual functional prognosis of the patient. The objective of our study was to evaluate the sexual functional prognosis of patients admitted for penile emergencies. Patients and Methods: We conducted a cross-sectional study from January 1 to 31, 2021, in the urology department of the University Hospital. Variables included sociodemographic, diagnostic, and evolutionary data of sexually active patients admitted for a penile emergency. Results: During this period, 68 patients were admitted for penile emergencies. We included 45 sexually active patients, with a mean age ranging from 34.5 ± 14.1 years with extremes of 16 and 90 years. The most frequent penile emergencies were priapism (62.2%) and penile fracture (22.2%), with a mean time for treatment of 21.4 ± 52.5 hours. The sexual functional prognosis was very satisfactory (normal erection) in 71.1% (n = 32) of patients. Loss of erectile function was observed in 4.4% (n = 2) of cases. Conclusion: Penile emergencies are relatively frequent, dominated by priapism and penile fracture in our context. The sexual functional prognosis is good.

关键词： Penile Emergency Diagnosis Sexual Functional Prognosis Libreville

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Acute Priapism: A Revealing Inaugural Mode of Chronic Myeloid Leukemia. A Case Report and Review of the Literature

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Open Journal of Urology 2022年第5期12卷 237-241页

作者： Dimitri Mbethe Adrien Mougougou Steevy Ndang Ngou Milama Said Mohamed Moudouni Izoudine Bissiriou Giscard Smith Olagui jean Massandé mouyendi Urology Department of the University Hospital of Libreville Libreville Gabon Urology Department of the Mohamed 6 University Hospital of Marrakech Marrakesh Morocco Urological and Visceral Surgery Department Omar Bongo Ondimba Armed Forces Instruction Hospital Libreville Gabon

Priapism is a painful and prolonged erection occurring without any sexual stimulation and not resulting in ejaculation. It most often occurs in patients with sickle cell disease. We report here the case of acute recurrent priapism revealing inaugural mode of CML in a 22-year-old patient with no particular pathological history. The study of the onco-hematological karyotype revealed a karyotype with 46 chromosomes with a clonal chromosomal anomaly: The t (9;22) “Philadelphia chromosome”. The evolution was favorable under imatinib.

关键词： Priapism Chronic Myeloid Leukaemia Philadelphia Chromosome

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