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Urological Emergencies at the University Hospital of Brazzaville: Epidemiological, Clinical, and Therapeutic Aspects

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Open Journal of Urology 2024年第5期14卷 333-345页

作者： Roland Bertile Banga-Mouss Yannick Dimi Nyanga Irène Ondima Armel Melvin Atipo Ondongo Steve Aristide Ondziel-Opara Joseph Junior Damba Nick Arnaud Monabeka Christ Ondzé Daniella Gloire Ngassiele Gidmard Onguele Henock Songa Jetsvy Mayala Anani Wensels Severin Odzebe Prosper Alain Bouya Departement of Urology and Andrology University Hospital of Brazzaville Brazzaville Republic of the Congo

Introduction: Urological emergencies play a significant role in the medical and surgical activity of a urology department. The objective of this study was to determine the hospital prevalence of urological emergencies at the University Hospital of Brazzaville (CHUB), identify the different pathologies requiring urgent care, and list the various therapeutic methods. Patients and methods: A retrospective study of patients admitted to the medical and surgical emergencies department of CHUB over a 5-year period. Patient records admitted and treated for a urological emergency were included. The variables studied were the frequency of urological emergencies, patient age at admission, gender, nature of the emergency, and various therapeutic options. Results: Urological emergencies accounted for 4.3% of all medical and surgical emergencies. The mean age was 57 ± 28 years with a range of 3 to 93 years. The male-to-female ratio was 7.1. The most common conditions were urinary retention (54.67%), hematuria (17.20%), and renal colic (8.13%). Therapeutically, surgical urinary drainage was dominated by cystostomy. Conclusion: Urological emergencies are infrequent at the University Hospital of Brazzaville. Their management is often delayed.

关键词： Urological Emergencies Urinary Retention Hematuria Renal Colic

Ischemic Priapism Management at the University Hospital, Brazzaville

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Open Journal of Urology 2021年第12期11卷 458-465页

作者： Rolland Bertille Banga Mouss Aristd Stève Ondziel Opara Armel Melvin Ondongo Atipo junior joseph damba Yannick I. Dimi Nyanga Daniela Glore Ngassiele Mathias Andzin Anani Wencesl Séverin Odzébé Prosper Alain Bouya Brazzaville Congo

Background: Priapism is defined as a prolonged and painful erection that persists beyond or is unrelated to sexual stimulation. Its frequency is high in sickle cell patients in our regions. Despite being a urological emergency, many patients are diagnosed at a late stage, increasing their risk of sequelae. In this article, we assessed the management of priapism in our department, with the aim of improving our daily clinical practices. Patients and Methods: We conducted a monocentric retrospective descriptive study from January 2005 to December 2020. All patients admitted and treated for priapism in our emergency department during the study period were included. The following variables were considered: age, sex, etiology, consultation delay, treatment type and outcomes. A follow-up visit was scheduled once at 1, 6 and 12 months post-treatment and the erectile function was evaluated during this visit. Results: In total 97 patients were treated during the study period. Priapism represented the 4th urological emergency after urinary retention, renal colic and hematuria. The mean age was 23.63 ± 11.5 years old. Sickle cell disease was observed in 59.8% of patients. Sixteen patients (16.50%) who consulted within 12 hours of priapism onset were successfully treated by oral or injectable etilefrine. Forty-three patients (44.33%) who consulted between 12 and 36 hours were successfully treated using distal spongio-cavernous fistula. After treatment, detumescence was obtained in 86 patients (88.66%). Eleven patients (11.34%), who consulted after the 36th hour, developed cavernous fibrosis with subsequent erectile dysfunction. Conclusion: Priapism represents the 4th cause of admission at our emergency department. Sickle cell disease was the main cause of ischemic priapism in our context. One patient in 2 consulted after 36 hours following the onset of symptoms. Medical treatment was effective in patients who consulted before 12 hours, w

关键词： Priapism Urological Emergency Sickle Cell Caverno-Spongy Shunt

Traumatic Penile Amputation Post Circumcision: A Series of 3 Cases

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Open Journal of Urology 2023年第11期13卷 517-524页

作者： Orock Agbor Tanyi Mbassi Achille Aurele Mekeme Mekeme junior Fouda Jean Cedrick Owon Abessolo Nwatchap Jean Jacques Awoundja Christain Pierre joseph Fouda Department of Surgery and Subspecialties Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Surgery Service Regional Hospital Ngoundere Ngoundere Cameroon Urology and Andrology Service Yaoundé Central Hospital Yaoundé Cameroon Department of Surgery and Subspecialties Higher Institute of Medical Technology Yaoundé Cameroon

Circumcision remains a frequently performed surgical procedure and could be associated with various complications, ranging from mild to catastrophic. Penile amputation is a rare and severe complication usually complex and challenging to manage. We describe three cases of penile amputation injuries following circumcision referred within a week at the urological service of the Yaoundé Central Hospital. The first case was a 5-year-old who had complete penile amputation during circumcision by a nurse assistant at a rural health center. The second was a 7-year-old boy who sustained total penile glans amputation while undergoing circumcision by a nurse under local anesthesia at a rural health facility. The third involved a 6-year-old who had total penile amputation with loss of the amputated stump during circumcision by a traditional practitioner at home. Non-microsurgical penile re-implantations were done with diverse outcomes. The preservation of the amputated stump, the ischemic time and the severity of injury are factors affecting surgical outcome. The aim of this study is to evaluate our management experience and outcome of penile amputation injuries in resource-limited settings. Microsurgical replantation remains the gold standard in the management of penile amputation injuries. However, in resource-limited settings macroscopic replantation could be used as an alternative remedy to salvage the amputated penis.

关键词： Circumcision Penile Amputation Surgical Management Complications

Temporal Variations in Physico-Chemical Parameters of Ground Water in Kibujjo Village, Namayumba Sub-County, Wakiso District, Uganda

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Journal of Water Resource and Protection 2022年第10期14卷 665-679页

作者： Godfrey Musumba junior Sembatya Derick Muloogi Chemistry Department St. Joseph’s Secondary School Butenga Masaka Uganda G & M Consultancy Masaka Uganda Chemistry Department St. Kizito High School Kampala Uganda Department of Energy Minerals and Petroleum Studies Mbarara University of Science and Technology Mbarara Uganda

Water is one of the essential life’s basic needs. However, the purity and quality of water from groundwater sources in developing countries are still in doubt due to contamination by different anthropogenic activities. This study assessed the temporal variations in physico-chemical parameters of water sources in Kibujjo Village, Wakiso District, Uganda. Water samples were collected from four water sources: two (2) wells and two (2) boreholes. The levels of both physical and chemical parameters were assessed using APHA standard analytical methods. The results indicated that most of the measured water quality variables did not exceed the UNBS and WHO standards for drinking water, and the majority of the water parameters positively correlated. Borehole waters had a better quality than well waters. The highest levels of most of the variables were recorded during the wet season. There was a significant statistical difference (p SO2-4 showed a significant difference in the dry season amongst the water sources but no significant difference during the wet season (p > 0.05). Therefore, water from wells is not recommended for drinking before treatment, most especially during the wet season.

关键词： Ground Water Physico-Chemical Parameters Temporal Variation

Comparison of Transrectal Prostate Digital and Ultrasound-Guided Core Biopsies in 400 Men in a Low-and-Middle Income Country

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Open Journal of Urology 2023年第10期13卷 418-432页

作者： junior Barthelemy Mekeme Mekeme Oriol Landry Mbouche Figuim Bello Bright Che Awondo Aurele Achille Mbassi Cedrick Jean Fouda Tax Liendi Marcella Biyouma Guillaume Gayma Marcel junior Yon Mekeme junior Ngue Ngue Mabah Paul Adrien Atangana Pierre Ongolo Zogo Pierre joseph Fouda Noel Coulibaly Angwafo III Fru Maurice Aurelien Sosso Faculty of Medecine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department and Urology and Andrology Yaounde Central Hospital Yaounde Cameroon Higher Institute Medical Technology Yaounde Cameroun Anatomy and CytoPathology Laboratory “Centre Pasteur” Yaounde Cameroon Felix Houphouet Boigny University of Cocody Abidjan Ivory Coast

Background: The diagnosis of prostate cancer (PCa) relies on clinical assessment with digital rectal examination, serum PSA and histological examination. Limitations in our technical facilities, high financial cost of ultrasound-guided biopsy often prevent us from implementing the guidelines on the practice of prostate biopsy. Methods: We conducted a retrospective and cross-sectional descriptive study comparing digital-guided and ultrasound-guided transrectal prostate biopsy of 400 patients over a period of 12 years in the Yaounde Central Hospital. We reviewed files of patients who underwent digital and ultrasound guided biopsy procedures. 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: Out of the 400 patients, 292 digital-guided transrectal biopsies (73%) and 108 ultrasound-guided transrectal biopsies (27%) were performed in patients who were suspected of having prostate cancer (PCa). Patients were aged between 39 to 90 years. Both procedures were effective in identifying prostate cancer. Gleason score between 2 to 10 detected prostate adenocarcinoma for 301 patients (75.2%). The complications included anal pain, rectal bleeding, hematuria and urinary tract infections, with an occurrence rate similar for both ultrasound-guided (2.25%) and digitally-guided techniques (2.5%). Seven patients (1.75%) required hospitalization for management of complications. The mortality rate was null. Conclusion: Both techniques are effective in detecting PCa with the similar complication rates. Digital-guided trans-rectal prostate biopsy still has its place in a resource-limited setting like ours.

关键词： Prostate Biopsy Digital Guided Ultrasound Guided Adenocarcinoma Gleason Score

Surgical Management of Adrenal Tumors: Experience of Three Tertiary Hospitals in Yaounde, Cameroon

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Open Journal of Urology 2023年第11期13卷 495-516页

作者： junior Barthelemy Mekeme Mekeme Etoa Ndzie Agbor Orock Tanyi Jean Cedrick Fouda Achille Aurele Mbassi Philip Owon Abessolo Bright Che Awondo Marcel junior Yon Mekeme Pierre Ongolo Zogo Pierre joseph Fouda Eugene Sobngwi Zachary Sando Angwafo III Fru Department of Surgery and Subspecialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Urology and Andrology Department Yaounde Central Hospital Yaounde Cameroon Endocrinology Department Yaounde Central Hospital Yaounde Cameroon Radiology Department Yaounde Central Hospital Yaounde Cameroun Anatomy Cytopathology Department Yaounde Gynecology Obstetrics and Pediatrics Hospital Yaounde Cameroon

Introduction: Surgical management of adrenal tumors has greatly improved over the past years, with laparoscopic adrenalectomy being the gold standard. However, Open adrenalectomy is indicated in large adrenal tumors, malignant tumors and large phaeochromocytomas. We report surgical outcomes of 18 cases of functional adrenal tumors from 2007 to 2022. Methods: We conducted a retrospective cross-sectional and descriptive study in three tertiary hospitals in Yaounde, Cameroon. We reviewed files of patients who underwent adrenalectomy over a period of 15 years from July 2007 to July 2022. Clinical and diagnostic components of adrenal tumors, indications and surgical outcomes were analyzed. Results: A total of 18 patients were included in our study. The average age of patients was 38.33 years, with a female-to-male sex ratio of 2:1. Weight gain (72.2%) was the most represented clinical sign. The secretory nature of tumor and malignancy represented 55.5% and 33.3% of the operative indications and all 18 (100%) of the patients had open adrenalectomy. Vascular injury was the most common intraoperative complication with 5.63%, while acute adrenal insufficiency (16.7%) was the most common post-operative complication. The average tumor size was 6.22 cm and the mean duration of hospitalization was 11.61 days. Adenoma 7 (38.9%) and adrenocortical carcinoma 5 (27.8%) were the frequent histological types. One patient died two months post-surgery from anemia-related complications. Conclusion: The success of adrenal surgery is linked to multidisciplinary patient care and the experience of the surgeon. Conventional surgery still has indications with satisfactory short- and medium-term results in our context.

关键词： Adrenal Tumors Surgical Management Outcome Yaounde

Testicular Burkitt’s Lymphoma: A Case Report and Literature Review

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Open Journal of Urology 2023年第9期13卷 327-336页

作者： junior Bathelemy Mekeme Mekeme Jean Cedrick Fouda Philip Fernandez Owono Abessolo Axel Nwaha Makon Marcella Delboise Biyouma Georges Kemegni Atenguena Christian Awoundja Marcel junior Mekeme Yon Ngapagna Paul Adrien Atangana Pierre Ongolo Zogo Etoundi Paul Owono Pierre joseph Fouda Angwafo III Fru Faculty of Medicine and Biomedical Sciences of the University of Yaoundé 1 Yaoundé Cameroon Urology and Andrology Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Medicine and Pharmacological Sciences University of Douala Douala Cameroon Laboratory of Anatomy and Cytologic Pathology of Yaoundé Centre Paster Yaoundé Cameroon

Background: Burkitt’s lymphoma of the testis (TBL) is a rare and extremely aggressive malignant usually diagnosed in front of a testicular mass. We describe an interesting single case of TBL managed by a combined multimodal approach with a review of the literature. Case Report: A patient aged 69-year-old male, newly hypertensive, who presented with a twelve-month history of right testis progressive painful scrotal swelling, which worsens following a motorbike accident. Clinical examination revealed a large tender mass in an erythematous right scrotal bursa. A scrotal ultrasound showed a right heterogenous intra-testicular mass. The patient underwent unilateral (right) radical orchiectomy. Histopathological examination revealed presence of monomorphic lymphoid cells, with moderate to increased size, dissociated inconstantly by macrophages consistent with a Burkitt’s-like non-Hodgkin Lymphoma. After surgery, the patient was transferred to oncologist for adjuvant chemotherapy. Conclusion: A testicular mass is a usual circumstance for the discovery of a primary tumour of the testicle. Burkitt’s testicular lymphoma is a rare tumour whose diagnosis is based on histological findings. There are non-consensual etiological or predisposing factors. The treatment depends imperatively on the stage of the disease. Therapeutic modalities relay on in surgical excision, chemotherapy and radiation therapy but the accurate procedures are not standardized.

关键词： Burkitt’s Lymphoma Orchidectomy Testis

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 performed in 68% of cases while 48% received medical tr

关键词： Urogenital Prolapse Cystocele Hysterocele Clinical Surgery

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