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Interventional Ultrasound in Ambulatory Urological Practice: Experience of the Medicis Clinic in Conakry

Open Journal of Urology 2024年第8期14卷 458-473页

作者： Daouda Kanté Alexandre Vahina Gamamou lahoumbo ricardo gnammi Aboubacar Cherif Abdoulaye Bobo Diallo Telly Sy Urology Department Faculty of Health Sciences and Techniques Conakry Ignace Deen National Hospital in Conakry Conakry Guinea Medicis Clinic Conakry Guinea

Introduction: Minimally invasive urological interventions have long been practiced blindly in our context. The popularization of ultrasound in urological practice has contributed to changing habits by making the procedures safer and more effective. The objective of this work was to study the technical aspects, indications and results of minimally invasive urological procedures guided by ultrasound. Material and methods: This was a prospective descriptive study lasting 1 year from January to December 2023 at the Médicis clinic in Conakry. Results: We carried out 126 ultrasound-guided urological interventions in one year, including 6 percutaneous nephrostomies (NPC), one renal cyst puncture-aspiration-sclerotherapy, 102 prostate biopsies, 5 drainages by transrectal aspiration of prostatic abscesses, 10 placements of cystostomy probes. Suprapubic, 2 puncture-aspiration-sclerotherapies for vaginal hydroceles. The average age of our patients was 69 years and the predominant age range was 61 - 70. The majority of our patients were male (97.61%) with a sex ratio of 41 men to one woman. Ultrasound-guided urological interventions were for diagnostic purposes (80.95%), for therapeutic purposes (15.77%) and for diagnostic and therapeutic purposes (3.96%). The indications for ultrasound-guided urological interventions were dominated by prostate pathologies (84.91%). The majority of interventions were performed rectally (84.92%) versus (13.43%) abdominally and only 1.58% scrotalally. All procedures were performed in B-ultrasound mode under local anesthesia and on an outpatient basis. For therapeutic interventions, the patients were seen again one month after the procedure, the clinical examination and ultrasound control found the evolution to be favorable. Conclusion: ultrasound is useful in urological practice for guiding minimally invasive interventions. The indications for ultrasound-guided procedures in urology are dominated by prostate pathologies. These procedures are safe

关键词： Biopsy Ultrasound-Guided Interventions Minimally Invasive Nephrostomy

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Prevalence and Clinical Anatomic Characteristics of Cryptorchidism in Schools in the City of Conakry

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Open Journal of Urology 2020年第12期10卷 293-299页

作者： Thierno Mamadou Oury Diallo Mamadou Diawo Bah Daouda Kante Mamadou II. Barry Demba Cisse Mamadou Bissiriou Bah lahoumbo ricardo gnammi Ibrahima Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah Urology Andrology Department of Ignace-Deen Hospital HUC of Conakry Conakry Guinea Gamal Abdel Nasser University Conakry Guinea

Objective: To report the prevalence, anatomic and clinical characteristics of cryptorchidism in schools in the city of Conakry. Material and Methods: We carried out a 6-month cross-sectional study which took place in 32 public and private general education establishments in the city of Conakry. Each student boy was interviewed and examined;some information was collected from parents over the phone. Results: The prevalence of cryptorchidism was 3.6%. It was higher among children of mothers who were not in school, and among those who attended public institutions. The average age of students with cryptorchidism was 9.84 ± 2.33 years, with extremes of 4 and 17 years. 85% of these pupils were born in a care structure (CHU, municipal hospital, health center). Cryptorchidism sat on the right in 64 cases (37.4%), on the left in 44 cases (25.7%), it was bilateral in 63 cases (36.9%). The testicle was palpable at the inguinal level in 77 cases or 45% of the cases. Conclusion: Many school children have cryptorchidism at advanced ages, thus exposing them to the risk of complications (infertility and malignant degeneration of the testicle). Raising awareness among the various players could reverse this trend.

关键词： Cryptorchidism Prevalence Pupils School

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Clinico-Biological Profile of the Azoosperm Patient at the Urology and Andrology Department, Conakry University Hospital

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Open Journal of Urology 2020年第12期10卷 300-308页

作者： Mamadou Diawo Bah Thierno Mamadou Oury Diallo Daouda Kante lahoumbo ricardo gnammi Mamadou Bissiriou Bah Demba Cisse Mamadou II. Barry Ibrahima Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah Mamadou Bobo Diallo Urology Andrology Department of Ignace-Deen Hospital HUC of Conakry Conakry Guinea Gamal Abdel Nasser University Conakry Guinea

Objective: Azoospermia is one of the most important causes of couple infertility. The objective of our study is to report the clinical-biological profile of the azoosperm patient to the Urology-Andrology Department of the Conakry University teaching Hospital. It aims to take stock of the diagnostic management of azoospermia at this time where the world scientific community seems to be turned towards the intracytoplasmic sperm injection in the treatment of men with severe spermiological dysfunction. Patients and Method: This was a descriptive retrospective study lasting 12 months from January 1 to December 31, 2015. It collected 151 patients out of a set of 544 follow-ups for desire to have children. Were included the patients whose files contained all the information of the clinical observation (general information, reason for consultation, evolution, history, data of the physical examination) and a paraclinical assessment consisting of the FSH level and two spermograms spaced three months, confirming the diagnosis of azoospermia. Results: The mean age was 36.4 years with extremes of 23 and 56 years old. Urogenital infections (36.4%) followed by a notion of inguinal surgery had been the main patients’ history. Primary infertility accounted for 76.8% of cases. The mean duration of infertility was 6.5 years with extremes of 2 and 19 years. Azoospermia affected 27.76% of patients who consulted for the desire to have a child. It was judged secretory in 59.6% of cases, excretory in 25.8% of cases, and undetermined in 14.6% of cases. Varicocele was the main associated abnormality (46.3%) followed by testicular hypotrophy (36.4%). Neisseria Gonorrhoeae was the most common germ in sperm culture (21.7%). Chlamydia serology was positive in 21.7% of patients. Conclusion: Azoospermia affects a non-negligible proportion of men admitted by consulting for desire to have a child in our context. Strengthening the di

关键词： Male Infertility Azoospermia Conakry

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Endoscopic Internal Urethrotomy (EIU): Results of a Dynamic Study at the Urology-Andrology Department of the University Hospital Center (UHC) of Conakry

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Open Journal of Urology 2021年第11期11卷 427-435页

作者： Mamadou II Barry Demba Cissé Moussa Gnalen Diakité lahoumbo ricardo gnammi Thierno Mamadou Oury Diallo Mamadou Diawo Bah Mamadou Bissiriou Bah Alimou Diallo Daouda Kanté Ibrahima Bah Ibrahima Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah University Hospital Center of Conakry Urology Andrology Department of Ignace-Deen Hospital Gamal Abdel Nasser University Conakry Guinea

Introduction: Endoscopic internal urethrotomy (EIU) is a technique that consists of an incision of the stenosed urethra under visual control. Its indication is widespread since the first description in 1971 by Sachse. The objective was to analyze the results of EIU in the treatment of urethral stenosis (US) at the Andro-Urology Department of the UHC of Conakry. Methodology: It is a prospective descriptive study, lasting 18 months (January 2016-30 June 2017). It involved 102 patients. The variables were: age, etiology of US, type of catheter, duration of catheter wear and recurrences. After a 12-month follow-up, our results were considered good in the absence of recurrences. Results: The average age was 54.25 years with the extremes comprising between 16 and 96 years. The main reasons for medical checkup were chronic urine retention at 58.82%. Etiology infection was the most frequent with a ratio of 81.37%, while Escherichia coli was found at 51.29%. US was bulbar (71.57%), unique (67.64%) and less than 1 cm (60.78%). Surgical complication occurred with 9 patients (8.82%) with urethrorrhagia and the external genital organs infiltration in 4 cases. Results were good for 77 patients (75.49%). Stenosis post infection, long and multiple stenoses, urethral catheterization with latex catheter and urethral catheterization of more than 4 days were strongly associated with the recurrence occurrence. Conclusion: The EIU is a minimally invasive surgical technique that offers good results.

关键词： Urethral Stenoses Endoscopic Urethrotomy Conakry

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Comparative Study of Transvesical and Retropubic Prostatic Adenomectomies in the Urology-Andrology Department of Ignace Deen University Hospital Center

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Open Journal of Urology 2024年第4期14卷 227-243页

作者： lahoumbo ricardo gnammi Demba Cissé Vahina Alexandre Gamamou Daouda Kanté Mamadou Diawo Bah El-Mouksitou Akinocho Sabi Couscous Hassiatou Abdul-Haqq Bah-L’Imam Thierno Oumar Diallo Thierno Mamadou Oury Diallo Ibrahima Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah Department of Urology-Andrology Ignace Deen UHC Conakry Republic of Guinea School of Public Health Free University of Brussels Brussels Belgium Medical Imaging Department Ambroise Pare Clinic Conakry Guinea

Objective: To compare the results of transvesical and retropubic prostatic adenomectomies at the Urology-Andrology Department of Conakry University Hospital. Methodology: This was a prospective multi-operator analytical study lasting 6 months. It included 70 patients operated on for benign prostatic hypertrophy (BPH), divided into 2 groups of 35 according to the retropubic or transvesical technique. The data was collected using a questionnaire and entered into the Epi info application. The analysis was initially descriptive and then univariate. To identify confounding factors, a multivariate analysis was performed. The application conditions of each test were checked before their application. A p-value Results: Upper adenomectomies represented 53.6% of surgeries performed for BPH. The average age was 73.2 years. The mean prostate volume was 117 ± 51.6 cc and the mean total PSA was 9.2 ± 11.4 ng/ml. The majority of patients had an ASA1 (60%) and ASA2 (37.1%) score. Spinal anesthesia, a double-current silicone probe with hinged hinge 22, and drainage of the prevesical space were carried out in all patients, i.e. 100%. The average overall blood loss was 229 ± 98.2 ml. It was lower in the group of patients operated via the retropubic route (187 ± 60.4 ml). The same was true for the duration of intervention (49.1 ± 7.17 vs 55.4 ± 7.9 min), the catheter wearing time (5.14 ± 0.97 vs 9.29 ± 2 .9 days) and the length of hospitalization (=6.26 ± 1.15 vs 12.1 ± 5.74 days). Conclusion: The retropubic technique has advantages over the transvesical one. These advantages are translated by a gain in the duration of the intervention, blood loss, catheter wearing time and length of hospitalization.

关键词： Upper Adenomectomies BPH Retropubic Approach Transvesical Approach Conakry

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Transection Type, Vesico-Vaginal Fistula Surgery

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Open Journal of Urology 2020年第11期10卷 263-274页

作者： Mamadou II. Barry Ibrahima Sory Diallo Mamadou Bissiriou Bah Demba Cisse Thierno Mamadou Oury Diallo Mamadou Diawo Bah lahoumbo ricardo gnammi Thierno Oumar Diallo Kindy Diallo Daouda Kante Ibrahima Bah Karamoko Bano Sow Abdoulaye Bobo Diallo Oumar Raphiou Bah Sékou Guirassy Mamadou Bobo Diallo Urology Andrology Department of Ignace-Deen Hospital HUC of Conakry Conakry Guinea Gamal Abdel Nasser University Conakry Guinea Labé Regional Hospital Urology Unity Conakry Guinea

The objective of the study was to report the results of the surgery of the Vesico-vaginal fistula (VVF) transection types at CHU Conakry. Methods: This was a prospective descriptive study that focused on 64 patients operated for VVF transection type at the Urology department of CHU Conakry between January 2013 and December 2015. Four types of transection were defined according to the state of the urethra and vagina, the size of the fistula, the peri-fistulous tissue and associated lesions. The variables studied were the proportion of transection, age, the type of transection, the number of previous cures, the operative technique, the complications and the results after a follow-up of 3 months. Results: Transection accounted for 47.05% of the obstetric fistulas. The average age was 25.18 years old (14-43 years old). This was a Type I transection (11 cases), type II (27 cases), type III (19 cases) and type IV (7 cases). The surgical approach was vaginal in 64 cases. Fistulorraphy with a confection of a new cervix and cervico-urethral anastomosis was conducted in 19 patients, combined with bladder flap urethroplasty (30 patients) or vaginal flap (15 others). We recorded healing in 37 cases. Conclusion: Transection type VVF is a severe VVF. The preferential surgical approach was vaginal. Technical difficulties were related to associate lesions and the continence system affected.

关键词： Vesico-Vaginal Fistula Transection Surgery

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Cancer on Testicle Not Descended: Clinical and Therapeutic Aspects of 7 Cases

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Open Journal of Urology 2020年第5期10卷 158-166页

作者： Bah Mamadou Bissiriou Barry Mamadou II Bah Ibrahima Sine Babacar gnammi ricardo Cissé Demba Sow Yaya Diao Babacar Department of Urology Andrology of the Ignace Deen National Hospital CHU of Conakry Conakry Guinea Department of Urology Andrology of Aristide Le Dantec Hospital Dakar Senegal

Objective: To study the clinics and therapeutics of testicular cancer not descended in Senegal. Patients and Methods: This is a retrospective study over a period of 15 years between January 1997 and January 2012. It focused on 07 patients. Results: The average hospital incidence was less than one case per year. The average age of patients was 30.7 years with a median of 28 (range, 21 years and 38 years). The reasons for consultation were dominated by the existence of an abdominal or pelvic mass associated with an emptiness of the stock market. Orchiectomy was the main therapeutic gesture. It was performed by transperitoneal route. CT-TAP was performed in all cases and revealed a tumor independent of the liver of the spleen or kidneys, developed on an undescended testicle. Four cases of lumbar-aortic lymph node metastasis were noted. Histologically, we noted four cases of embryonic carcinoma and three cases of seminoma. Four patients died within six months postoperatively. Two in an intestinal obstruction chart, one in a peritoneal carcinomatosis chart and one patient in a pulmonary embolism chart. Two had a 4-year survival without recurrence. One patient had a 7-year survival without recurrence. At the time of the counting, these three patients were lost sight off. Conclusion: Intra-abdominal or pelvic development of testicular cancer is rare. It constitutes a major subsequent risk of the undescended testicle.

关键词： Cancer Undescended Testicle Embryonic Carcinoma Seminoma

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