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Endoscopic Internal Urethrotomy in the Treatment of Male Urethral Stenosis in the Urology-Andrology Department of KARA 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 Komi Hola Sikpa Edoe Viyome Sewa Messan Semefa Agbedey Gnimdou Botcho kodjo tengue Tchilabalo Matchonna Kpatcha 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 Kara Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of Kara 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 Kara Togo

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： kodjo tengue Edoé Viyomé Sewa Komi Hola Sikpa Gnimdou Botcho Essodina Padja Matchonna Tchilabalo Kpatcha Ekoué 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 knowledge for adequate therapeutic decisions, as they can compromise the functional prognosis of concerned organs.

关键词： Genital Organs Trauma Scrototomy Togo

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 Kpatcha Tchin Darré Edoe Viyome Sewa Komi Hola Sikpa Gnimdou Botcho Essodina Padja Essomendedou Adolphe Leloua kodjo 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

Background: 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

Urological Emergencies at Kara 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： Komi Hola Sikpa Tchilabalo Matchonna Kpatcha kodjo tengue Gnimdou Botcho Edoe Viyome Sewa Sabi Rachid Sade Messan Semefa Agbedey Pwerew Rodolphe Plante Kossi Edem Gueouguede Kara Teaching Hospital Kara Togo

Background: The urology department of the teaching hospital of Kara 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 take stock of urological emergencies at the teaching hospital of Kara. Objective: To describe the epidemiological, clinical, and therapeutic aspects of urological emergencies received at the teaching hospital of Kara. 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 Kara, 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 Kara Togo

Erectile Dysfunction in Hemodialysis in Togo

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Open Journal of Nephrology 2016年第4期6卷 145-150页

作者： Kossi Akomola Sabi Béfa Noto Kadou Kaza Eyram Yoan Amekoudi Jacques Vigan Souleymane Pessinaba Kafui Avouwadan kodjo tengue Tchilabalo Matchona Kpatcha Dazé Apollinaire Gnionsahe Departement of Nephrology and Hemodialysis Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Cotonou Cotonou Benin Departement of Cardiology Campus University Teaching Hospital of Lomé Lomé Togo Departement of Urology and Andrology Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Yopougon Abidjan Ivoiry Coast

Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 to February 2016 in the hemodialysis unit of CHU SO, only dialysis center in the country. The evaluation of the ED was made through IIEF-5 questionnaire. Results: 39 men (67.2%) of 58 hemodialysis is a sex ratio M/F of 2.05. The average age was 43.5 years with extremes of 25 and 59 years. The majority of men had a profession in 19 cases (48.7%). The mean duration of dialysis was 30 months with a range of 4 months and 90 months. Initial glomerular nephropathy was in 19 cases (48.7%) and vascular in 14 cases (35.9%). 38 patients were hypertensive (97.4%) and 6 diabetic men (15.4%). The prevalence of ED was 74.3% (29 cases). ED score was less than 10 points in 14 cases (35.9%);01 case (2.6%) between 11 and 16 points;06 cases (15.4%) between 17 to 21 points;08 cases (20.5%) between 22 and 25 points;and 10 cases (25.6%) between 26 and 30 points. Age, profession and duration of dialysis were risk factors associated with ED (P 0.001). Conclusion: The prevalence of ED is very high in Togo.

关键词： Erectile Dysfunction Hemodialysis Togo

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 Kpatcha Tchin Darré Essodina Padja Adolphe Essomindedou Leloua Gnimdou Botcho Edoé Viyomé Sewa kodjo tengue Komi Hola Sikpa Ekoué 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

Background: 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 taken 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 taken into each abnormal area at rectal examination. The follow-up have been done during twelve weeks. 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

Male Urethral Stricture: Epidemiological, Clinical, and Therapeutic Aspects in Kara

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

作者： Komi Hola Sikpa Gnimdou Botcho Edoe Viyome Sewa Sabi Rachid Sade Essomindedou Leloua Messan Semefa Agbedey Essodina Padja Kossiwa Rose Assou kodjo tengue Tchilabalo Matchonna Kpatcha Kara Teaching Hospital Kara Togo Sokode Regional Hospital Center Sokode Togo Sylvanus Olympio Teaching Hospital Lomé Togo

Background: Urethral stricture is a pathology frequently encountered in urological practice. Management is often surgical, with possible recurrences. What about this pathology in Kara, a semi-urban city? Objective: Assess the management of male urethral stricture in Kara. 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 Kara, from December 2020 to December 2022. All cases of male urethral stricture, surgically treated at the teaching hospital of Kara, 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 Kara. 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 Kara Togo

Urological Endoscopy: Results of the First 15 Months, in Kara (Togo)

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

作者： Komi Hola Sikpa Gnimdou Botcho Messan Semefa Agbedey Essodina Padja Essomindelou Leloua Kossi Edem Gueouguede Pwerew Rodolphe Plante Edoe Viyome Sewa kodjo Kevin tengue Matchonna Tchilabalo Kpatcha Centre Hospitalier Universitaire Kara Kara Togo Centre Hospitalier Regional Sokodé Sokodé Togo Centre Hospitalier Universitaire Sylvanus Olympia Lomé Togo

Background: The urology department of the Teaching Hospital of Kara is the 2nd urology department in Togo, Kara being a semi-urban town located 400 km 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 Kara 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 Kara 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 Kara Teaching Hospital, the results are already promising after less than 24 months of endoscopic practice in urology. Advocacy must be made to political decision-makers, so that the situation is even better, for the good of both urologis

关键词： Urological Endoscopy Results Kara Togo

Experience with Open Prostatectomy in Lomé, Togo

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Open Journal of Urology 2016年第5期6卷 73-79页

作者： Tchilabalo M. Kpatcha Boyodi Tchangai kodjo tengue Fousséni Alassani Gnimdou Botcho Tchin Darre Essomindedou Leloua Komi H. Sikpa Edoe V. Sewa Tsipa Anoukoum Komlan Gnassingbe Department of Urology the University Teaching Hospital of Lomé Togo Departement of Surgery the University Teaching Hospital of Lomé Togo Department of Pathology the University Teaching Hospital of Lomé Togo Department of Pediatric Surgery the University Teaching Hospital of Lomé Togo

Background: Open prostatectomy is the most commonly available surgical procedure for benign prostatic hyperplasia and this is the case in most countries in West African even with all the limitations of the procedure. Objective: The objective is to determine the pattern and outcomes of open prostatectomy in Lomé. Patients & Methods: From December 2011 to November 2012, we conducted a descriptive cross-sectional study on a series of patients treated for prostate adenoma. Dysuria was assessed using the International Prostate Symptom Score (IPSS). The history of each patient was recorded, as well as paraclinical data. All patients were surgically treated via abdominal incision procedure. The data obtained included the patients’ demographics, clinical features, the IPSS scores, investigations, type of open prostatectomy, outcome and follow-up. The data were analyzed for means and frequencies using Epi Info version 3.5.3. Results: Fifty-four consecutive patients underwent surgery consecutively, their ages ranging from 40 to 92 years, with an average of 67.27 ± 12.50 years. In all, 46 (85.2%) patients presented with obstructive symptoms and 26 (48.1%) presented with urinary retention. The average prostate volume was 114.31 ± 20.11 cm3 with a range of 31 - 485 cm3. The average blood loss at surgery was 425.92 ± 38.2 ml with an average operating time of 66.05 ± 15.75 mins and the main complications were hemorrhaging and clot retention in 7 (13%), epididymo-orchitis in 9 (16.7%), and urinary incontinence in 6 (11.1%) patients. IPSS scores were under 7 in 92% of patients three months after surgery and the mortality rate was 3.7%. Conclusion: This study has shown that open prostatectomy in our environment is still the commonest surgical option for benign prostatic hyperplasia with good outcomes though with manageable complications.

关键词： Open Prostatectomy Benign Prostate Hyperplasia Good Outcome Complications Lomé Togo