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Recent Injuries of External Genitalia: Clinical Aspects and Management

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Open Journal of Urology 2015年第9期5卷 161-166页

作者： Kimassoum Rimtebaye kaboro mignagnal Arya Zarif Agah Tashkand Franklin Danki Sillong Lamine Niang Gueye Serigne Magueye Hopital Général de Référence Nationale N’Djamena Chad Hopital Protestant de N’Gaoundéré N’Gaoundéré Cameroun Hopital Grand Yoff de Dakar Dakar Sénégal

Aim: Report the epidemiological, clinicopathological characteristics and ensuring management of recent traumas of the external genitalia in Urology. Methods: This was a descriptive retrospective study of 47 cases of patients suffering from recent traumas of the external genitalia over a period of 5 years. The variables studied were sociodemographic, clinical, paraclinical, therapeutic and evolutionary. Results: A total of 47 patients, including 46 men, were managed. The mean age was 26.8 years, ranging from 6 to 56 years. The circumstances of occurrence were: the missteps of coitus (n = 16), traffic accidents (n = 9) and criminal injuries (n = 8). The fracture of the penis (n = 16) was the most common lesion followed by the scrotal wound (n = 11). The management was medical and surgical and varied by the type of lesion. The outcome was favorable in 91.5% of cases. Conclusion: The incidence of traumas of the external genitalia was 9.4 in urology department in N'Djamena. Penis fracture was the frequent lesion. The management is multidisciplinary, medical and surgical.

关键词： Coitus Scrotum Penis External Genitalia Urology

Complete Urethral Duplicity: A Rare Cause of Urinary Incontinence, New Type According to Effman’s Classification

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Open Journal of Urology 2015年第10期5卷 182-187页

作者： Kimassoum Rimtebaye Franklin Danki Sillong Arya Zarif Agah Tashkand mignagnal kaboro Lamine Niang Serigne Magueye Gueye Hô pital Général de Référence Nationale (HGRN) de N’Djaména N’Djaména Tchad Hô pital Protestant de N’Gaoundéré N’Gaoundéré Cameroun Hô pital Général de Grand Yoff (HOGGY) de Dakar Dakar Senegal

Aim: To describe the clinical, anatomical, therapeutic aspects and propose a diagram of a new type of a complete urethral duplicity in classification of Effman. Material and Methods: This was a case report of a 14-year-old patient who suffered from birth of incontinence occurring while sitting with concept of preservation of normal urination. The patient was carrying two urethral meatus, one continent and the other incontinent. The two urethral meatus were easy to catheterize. The imagery was non-contributory. Resection of accessory urethra helped to make the patient continent. Informed consent was obtained from the patient’s parents for the surgical management, the anonymous use of record and photographs for scientific aims. Results: The diagnosis of urethral duplicity was retained. An explanatory approach is reported, a new scheme is proposed to improve the classification of Effman. Conclusion: The urethral duplicity is a rare urogenital abnormality whose etiology and pathophysiology are not fully understood and has not finished delivering the secret of his classification.

关键词： Urethral Duplication Epispadias Penis Kinking Notochord Sphincter

Urolithiasis: Diagnostic and Therapeutic Aspects in Urology Department of N’Djamena in Chad

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Open Journal of Urology 2015年第11期5卷 199-206页

Introduction: To study the clinical, paraclinical, diagnostic aspects and manage patients with urolithiasis according to the available technical facilities in urology department of N’Djamena in Chad. Urolithiasis is defined as the presence of one or more stony concretions located at any level of a segment of the urinary tract: calyx, renal pelvis, ureters, bladder and urethra. Materials and Methods: This was a descriptive type of a prospective study over a period of 4 years, from January 2008 to December 2011, involving 233 patients with urolithiasis treated in the urology department. Clinical and paraclinical examinations were the basis for the selection of patients. Informed consent of patient or their parents (for minors) was obtained for the anonymous use of records and photographs for scientific aims. Results: Urolithiasis represented 5.72% (233/4072) of all urological pathologies. Male dominance was significant with a sex ratio of 4.5/1. The age group of 0 - 10 years was the most affected with a staff of 67 (28.75%). The clinic was dominated by dysuria (44.63%), renal colic (33.91%) and hematuria (9.01%). The main anatomical location was bladder (62.23%). The management was essentially medical and surgical. We recorded 7 cases of death or post-interventional hospital mortality rate of 3%. Conclusion: Urolithiasis is a real public health problem in Chad. Due to the inadequacy of the technical platform, the management was based on the open surgery. Etiological research was impossible by lack of technical laboratory platform.

关键词： Urolithiasis Nephrectomy Cystolithotomy Calculi

Symptomatic Pelvic Kidney in Women at Childbearing Potential: Diagnostic Difficulties and Management in Urology Department of N’Djamena in Chad

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Open Journal of Urology 2015年第12期5卷 246-253页

作者： Kimassoum Rimtebaye Edouard Hervé Moby Mpah Arya Zarif Agah Tashkand Franklin Danki Sillong mignagnal kaboro Lamine Niang Serigne Magueye Gueye National General Referral Hospital of N’Djamena N’Djamena Chad Laquintinie Hospital of Douala Douala Cameroon Prostestant Hospital of N’Gaoundéré N’Gaoundéré Cameroon General Hospital of Grand Yoff of Dakar Dakar Senegal

Introduction: We aim to report, from three observations, the diagnostic difficulties and complications, and ensure the management of pelvic kidney in women at childbearing age in the Urology Department of the National General Referral Hospital of N’Djamena. Pelvic kidney is due to an abnormality of the migration that can be associated or not with a malrotation. Its symptomatology is not specific, causing diagnostic difficulties and therapeutic errors. Observation: There were three observations of female patients aged respectively 26, 29 and 32 years who were taken care of for years in the gynecology department for pelvic inflammatory disease before being routed in urology. The diagnosis of pelvic kidney was retained on the basis of morphological examination (ultrasound, intravenous urography, CT urography). The patients have undergone nephrectomy;the postoperative aftermath was simple. Conclusion: Pelvic kidney is a rare disease. It is often discovered during autopsy. Symptoms are non-specific;nephrectomy is the treatment of choice in symptomatic cases.

关键词： Pelvis Iterative Cesarean Malrotation Nephrectomy IVU

Etiology and Management of Complete Acute Urinary Retention in Urology Department in N’Djamena, Chad

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Open Journal of Urology 2017年第1期7卷 16-21页

作者： Kimassoum Rimtebaye Edouard Hervé Moby Mpah Arya Zarif Agah Tashkand Franklin Danki Sillong mignagnal kaboro Lamine Niang Serigne Magueye Gueye National General Referal Hospital of N’Djamena N’Djamena Chad Laquintinie Hospital of Douala Douala Cameroon Protestant Hospital of N’Gaoundéré N’Gaoundéré Cameroon Grand Yoff General Hospital of Dakar Dakar Senegal

Goal: To study the epidemiological, clinical, etiological, characteristics and ensure earlier management of complete acute urine retention (CAUR) in the urology department of N’Djamena in Chad. Patient and Method: It was a retrospective descriptive study of a sample of 606 patients during the period ranging from November 2008 to December 2010. The patients were consulted first in urology or referred by a colleague for a CAUR. The diagnosis was confirmed by an earlier clinical examination. The patients have benefited from a urine evacuation before looking for the etiologies. Results: We managed a sample of 606 patients suffering from CAUR. Average age was 60 years old with extremes of 1 month and 100 years. There were more patients in the ranks of 60 years and more (n = 436;71.94%). Men were more than women in the proportion of 583/25, and 63.20% of the patients lived In N’Djamena. The benign prostatic hypertrophia was the first cause of CAUR, followed by urethral stricture, urinary infection, lithiasis of the lower urinary tract, adenocarcinoma of the bladder, hymen imperforation in young girls, bilharzias, paraphimosis and ovenbird necrosis. The bladder catheterization was the most urgent gesture done in 61.71%, followed by open cystostomy. In the second case, etiological treatment was done as: open prostatic surgery (n = 306), urethral reconstitution (n = 58), cystololithotomia (n = 54), dilatation of urethral conduct (n = 54), hymenostomia (n = 6). Conclusion: CAUR was the first symptom which motivated the consultation in the department of urology in N’Djamena the main problem of public health in Chad.

关键词： CAUR Prostrate Urethra Lithiasis Bilharziasis Catheterization

Epidemiological, Clinical and Management of Benign Prostatic Hypertrophia in Urologie Department in N’Djamena, Chad

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Open Journal of Urology 2017年第1期7卷 9-15页

Aim: To determine the epidemiological, clinical, paraclinical characteristics and assess the result of surgical treatment of benign prostatic hyperplasia (BPH) in the urological department. Patients and Method: It is a retrospective descriptive study of 757 patient samples whose BPH diagnosis was pronounced and have benefited of the open surgery in urology department from January 2006 to December 2010. The variables studied were sociodemographical, clinical, paraclinical, therapeutical and the follow up. Those variables were: arterial tension, sonography, consultation reasons and hospitalization, the data provided rectal touch, the comorbidity, the prostatic specific antigen (PSA), other blood tests, urinary tests, medical management surgical treatment, the causes of death and the complications. Results: during the study period, 2406 patients were hospitalized, from them 1472 (61.18%) for low urinary tract diseases where 757 for BPH. The mean age was 64.18 years. The acute urine retention was the main cause of hospitalizations and consultations (51.51%). The rectal touch Helped in diagnosing 96.43% of cases. PSA in 74.10%, the sonography evaluated the volume of the prostate and the complications on the upper urinary tract, kidney dilatation and stones. An urgent evacuation of acute retention of urine in the bladder was done in 74.10%, a medical treatment was done in 33.47%. The open surgery was done in 66.47%. The evolution was good for 703 (92.86%), 54 died (7.14%) and the causes were various (anemia, hyperglycemia, HIV…). Conclusion: The BHP was the first reason of consultation and hospitalization in urology department in N’Djamena. Its diagnosis was done after the analysis of a beam clinical and paraclinical arguments. In the absence of an endoscopic resection column, open surgery was the only surgical treatment.

关键词： Benign Prostatic Hyperplasia Prostate Urology X Ray Surgery

Clinical, Paraclinical and Therapeutic Aspects of Chronic Prostatitis

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Open Journal of Urology 2017年第8期7卷 113-123页

作者： Kimassoum Rimtebaye Franklin Danki Sillong Arya Zarif Agah Tashkand Edouard Hervé Moby Mpah mignagnal kaboro Lamine Niang Serigne Magueye Gueye General Referral National Hospital of N’Djamena N’Djamena Chad Protestant Hospital of N’Gaoundere N’Gaoundéré Cameroon Laquintinie Hospital of Douala Douala Cameroon “Grand Yoff” General Hospital of Dakar Dakar Senegal

Aim: Present the clinical and paraclinical aspects of chronic prostatitis and report the management in urology. Methods: We conducted a retrospective descriptive study of 47 patients referred to the urology department from January 2011 to December 2013. Analysed variables were epidemiological (age, marital status, place of residence, occupation, education level, taking stimulants), clinical, paraclinical (CBU, chlamydia, syphilis and HIV serologies, urine culture susceptibility testing, semen analysis, ultrasound of urinary tree, radiographs, RCU, IVU), treatment and results. Results: The mean age was 44.6 years. The main reasons for consultation were dysuria (55.3%), prostatorrhea (29.8%) and sexual asthenia (12.8%). The general condition was satisfactory (80.9%). Purulent drop was objectified in the urethral meatus in 10.6% of cases, and the DRE was painful at 44.68%. Escherichia coli was the main isolated germ (23.4%). In 55.3%, calcification of the prostatic area was objectified to ultrasound of the urinary tract. The RCU had objectified bilharzia in 8.5% of calcifications of the bladder area and 19.14% of urethral stricture. The medical treatment was completed in all patients according to the etiology and complications by an instrumental or surgical treatment, offline or emergency. The outcome was favorable in 25 patients. Symptoms were improved in 12 others and a failure for the ten remaining. Conclusion: Chronic prostatitis is relatively frequent in urology. Clinical manifestations are diverse and varied. Treatment is difficult with a significant failure rate.

关键词： Prostate Infection Calcification Chlamydiae Schistomiasis

Diagnostic Approach and Management of a Unilateral Total Ectopy of the Scrotum

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Open Journal of Urology 2017年第9期7卷 139-145页

作者： Kimassoum Rimtebaye Choua Ouchemi Arya Zarif Agah Tashkand Franklin Danki Sillong Edouard Hervé Moby Mpah mignagnal kaboro Lamine Niang Serigne Magueye Gueye General Referal National Hospital of N’Djamena N’Djamena Chad Protestant Hospital of N’Gaoundere N’Gaoundere Cameroon Laquintinie Hospital of Douala Douala Cameroon “Grand Yoff” General Hospital of Dakar Dakar Senegal

Introduction: Total unilateral ectopy of the scrotum can be defined by the abnormal congenital anatomical position of the scrotum and its contents. The aim of the study is to describe the diagnostic and therapeutic approach of a total unilateral ectopy of the right scrotum. Methods: This is a clinical observation of a 46-year-old patient with a right abdominal mass evolving from birth. Analyzing the cluster of arguments clinically, operatively and anatomopathologically, allowed us to retain the diagnosis of a total unilateral ectopy of the right scrotum. The informed consent of the patient was obtained before the use of the images for scientific purposes. Conclusion: the unilateral total ectopy of the right scrotum is a rare congenital malformation of the external genitalia, which clinical diagnosis is difficult. Its management is surgical.

关键词： Testicular Ectopy Scrotum Medial Raphe Orchidopexia Gubernaculum

Diagnosing and Managing Androgen Insensitivity Syndrome

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Open Journal of Urology 2017年第11期7卷 219-225页

作者： Kimassoum Rimtebaye Edouard Hervé Moby Mpah Cyril Kamadjou Arya Zarif Agah Tashkand Franklin Danki Sillong mignagnal kaboro Lamine Niang Serigne Magueye Gueye General Referal National Hospital of N’Djamena N’Djamena Chad Laquintinie Hospital of Douala Douala Cameroon Protestant Hospital of N’Gaoundere N’Gaoundere Cameroon Grand Yoff General Hospital of Dakar Dakar Senegal

Introduction: Androgen insensitivity syndrome is a rare congenital abnormality of genital organs revealing a female phenotype in a person with XY chromosomes. The aim of our work is to describe the clinical aspects, to determine the chromosomal sex and to report our therapeutic management. Observation: A 28-year-old woman with female phenotype, feminine voice, normal breast development, normal underarms and pubic hair, absence of menstruation, fusion of small and large vaginal lips leaving a small pertuis to serve as urethral meatus. On the dorsal surface of the large, left lip was a mass the size of a date. Hormonal balance was normal. A feminizing genitoplasty was performed as well as excision of the mass. Histological analysis of the mass concluded that it was a feminizing testicular. Conclusion: Androgen insensitivity syndrome is a rare abnormality of the genitals. Multidisciplinary management is essential both for the designation of the breeding sex and feminizing genitoplasty.

关键词： Genital Malformation Androgen Genitoplasty Vaginoplasty Chromosomal Sex