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Management of Testicular Cancers in Brazzaville

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Open Journal of Urology 2024年第5期14卷 324-332页

作者： roland bertile banga-mouss Yanick Dimi Nyanga Brice Nkoua Epala Armel Melvin Atipo Ondongo Steve Aristid Ondziel-Opara Eliane Ndounga Alexis Bolenga Louis Constant Mbele Mantsouaka Judith Nsonde Malanda Aanani Séverin Wencesl Odzébé Prosper Alain Bouya Departement of Urology and Andrology University Hospital of Brazzaville Brazzaville Republic of the Congo Departement of Medicale Oncology and Radiotherapy University Hospital of Brazzaville Brazzaville Republic of the Congo

Introduction: Testicular cancer accounts for 5% of urological tumors, predominantly affecting young men. The aim of our study was to report the diagnostic and evolutionary aspects of testicular cancer cases treated in our center. Patients and Methods: A retrospective study conducted over a 15-year period involving 12 patients treated for testicular cancer at the University Hospital of Brazzaville. Results: The median age was 31 years (range 11 to 49 years), with a median consultation delay of 10.6 months (range 3 to 27 months). Scrotal mass was the most common reason for consultation. Cancer was bilateral in two patients. Two patients were admitted with metastatic disease. Histopathological examination favored germ cell tumors in 7 cases, two cases of non-Hodgkin’s malignant lymphoma, and one case of epididymo-testicular adenocarcinoma. Adjuvant chemotherapy resulted in complete remission in patients with germ cell tumors. However, neoadjuvant chemotherapy was not effective in patients admitted with advanced-stage disease. Conclusion: Testicular cancer is a rare condition that is curable in the majority of cases, but its management is often complicated in our setting due to delayed diagnosis caused by taboos surrounding genital organ pathologies.

关键词： Testicular Cancer Germ Cell Tumor Cisplatin Testicular Lymphoma Testicular Adenocarcinoma

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

Extrasurrenal Pheochromocytoma: A Case Report and Review of the Literature

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Open Journal of Endocrine and Metabolic Diseases 2023年第8期13卷 137-142页

作者： Nestor Ghislain Andzouana Mbamognoua roland bertile banga mouss Pierlesky Elion Ossibi Farel Ongoth Elilie Mawa Henri Germain Monabeka Department of Metabolic and Endocrine Diseases University Hospital of Brazzaville Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Urology Department University Hospital of Brazzaville Brazzaville Republic of the Congo Digestive Surgery Department University Hospital of Brazzaville Brazzaville Republic of the Congo

Introduction: Pheochromocytoma is a rare cause of endocrine hypertension. We report the case of an extra-adrenal pheochromocytoma discovered in the setting of an abdominal mass. Observation: The patient was 25-year-old and presented with headaches, excessive sweating and palpitations, followed by a sensation of abdominal weightlessness and diastolic arterial hypertension. Abdominal computed tomography revealed a retroperitoneal, right para-renal extra-adrenal mass. In biology, an increase in urinary methoxylated derivatives at the expense of normetanephrine. Conclusion: Pheochromocytoma is a rare disease, diagnosed by measuring urinary or plasma methoxylated derivatives. Conventional or nuclear imaging allows topographic diagnosis. Genetic studies helps to identify other tumors.

关键词： Pheochromocytoma Arterial Hypertension Methoxylated Derivatives Genetics

Anderson-Hines Open Pyeloplasty in the Treatment of Pyelo-Ureteral Junction Syndrome: Results from 36 Cases

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Open Journal of Urology 2019年第9期9卷 131-139页

作者： Anani Wencesl Severin Odzébé Caryne Mboutol-Mandavo Aristide Steve Ondziel Opara Lucie Irene Patricia Ondima Armel Melvin Ondongo Atipo Rolland bertile banga mouss Prosper Alain Bouya Department of Urology and Andrology University Hospital Brazzaville Congo Department of Padiatric Surgery Faculty of Health Science University Marien Ngouabi Brazzaville Congo

Goal: To evaluate the results and complications of open pyeloplasty according to Anderson-Hynestechnic. Patients and Methods: We conducted a retrospective study from 2000 to 2014. The study included 36 cases of opening the ureteropyelic junction operated pit syndrome according to Anderson-Hynes technique. Results: Lumbotomy was used in all patients. A pelvic pyelolithotomy for lithiasis was performed in two patients (5.5%) and unwinding of a lower polar pedicle in 3 cases (8.3%). The average duration of response was 119 ± 15 min. The average length of hospital stay was 11.2 ± 3 days. Patients were followed for a mean of 10 months. Thirty-five patients were asymptomatic and in one case lower back pain persisted. IVU to 6 months showed a permeable junction in 97.2% of cases. Seven patients (19.4%) had short-term complications. Ureteropelvic stenosis was the only complication in the medium and long term in one case (2.8%). The success rate of the Pyeloplasty was 97.2%. Conclusion: The open pyeloplasty as Anderson-Hynes remains the treatment of choice in our context SJPU with great results. The indications tend to decrease in favor of laparoscopic pyeloplasty.

关键词： Hydronephrosis Pyeloplasty Anderson Hynes Open Surgery

Penile Fracture at the Department of Urology and Andrology, University Hospital, Brazzaville

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Open Journal of Urology 2019年第12期9卷 195-200页

作者： Anani Wencesl Séverin Odzébé roland Bertille banga mouss Aristide Stève Ondziel Opara Joseph Junior Damba Armel Melvin Atipo Ondongo Aucloz Mouzenzo Prosper Alain Bouya Department of Urology and Andrology University Hospital Brazzaville Republic of the Congo

Objective: The objectives of this study, was to analyze epidemiological diagnosis, therapeutic option and evolutionary aspects. Materials and methods: This is a retrospective study regarding clinical data of nine penile fracture patients who have been admitted in the department of urology (university hospital, Brazzaville) from January 2006 to December 2018. The study parameters were: epidemiological, diagnosis, operative details, outcomes after treatment, and sexual disorders. Results: The mean age was 46.3 ± 14 years, ranged from 25 to 73 years. The etiology of penile fracture was coitus in 5 cases, masturbation in 3 cases and rolling of the penis on the bed in one case. 8 patients were managed surgically. The complications noticed in the postoperative period and during the follow-up visits were penile curvature in 2 cases, and erectyl dysfunction in 2 cases. Conclusion: The diagnosis of penile fracture remains clinic. Immediate surgical management is necessary for good functional result.

关键词： Penile Fracture Diagnosis Treatment Congo

Endoscopic Internal Urethrotomy Outcomes in the Management of Male Urethral Strictures

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Open Journal of Urology 2021年第12期11卷 452-457页

作者： roland Bertille banga mouss Aristide Stève Ondziel Opara Armel Melvin Ondongo Atipo Yannick I. Dimi Nianga F. C. Btchiv Joseph Damba J. P. Otilibili Anani Wencesl Séverin Odzébé Prosper Alain Bouya Department of Urology and Andrology of the University Hospital of Brazzaville Brazzaville Congo

Background: The aim of this study was to evaluate the outcomes of stricture treatment using endoscopic internal urethrotomy in the male urethra. Patients and Methods: We conducted a retrospective study from 2012 to 2017 at the Urology and Andrology Department of the University Hospital in Brazzaville, Congo. Medical records of 30 patients who underwent endoscopic internal urethrotomy for urethral stricture were analyzed. We studied the following variables: frequency of urethral stricture, age of patient, onset, cause and location of urethral stricture, duration of bladder catheterization, duration of hospitalization, and postoperative complications. The treatment outcome was assessed after a follow-up of 2.6 years (extreme: 2 and 4 years). Outcomes were considered successful or good when the patients had a normal urine flow and an unobstructed urethra at the Retrograde Urethrogram (RUG). Results: The mean age was 47.5 ± 9.7 years (range: 17 to 83 years). Dysuria was the most common symptom reported. We found that urethral stricture was mostly caused by infectious diseases (20 patients). The urethral stricture was located at the membranous urethra in 4 patients, the bulbar urethra in 25 patients, and the penile urethra in 1 patient. The mean duration of the bladder catheterization was 2.3 days. Hospitalization duration was 36 hours. We observed the following complications: urethrorrhagia in 3 patients, acute orchiepididymitis. We achieved good results in 23 patients. Conclusion: In our context where the practice of endoscopic internal urethrotomy is recent, it provides satisfactory results for the treatment of short urethral male stricture.

关键词： Stricture Male Urethra Endoscopic Internal Urethrotomy

Epidemiological Profile of Patients Suffering from Urolithiasis in African Urological Environments from 2016 to 2020

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Open Journal of Urology 2022年第2期12卷 157-167页

作者： Steve Aristide Ondziel-Opara Armel Melvin Ondongo Atipo Ghidmar Onguele Okemba Rolland Bertille banga mouss Yannick Isjody Dimi Nyanga Anani Wencesl Severin Odzebe Alain Prosper Bouya Department of Urology Andrology Brazzaville/Congo University Hospital Brazzaville Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo

Introduction: Urolithiasis is a very common pathology in the world. Its epidemiological profile varies from one region to another. In Africa in general and in the Congo in particular, it seems to be unknown. Objective: To determine the sociodemographic, diagnostic, therapeutic and evolutionary paraclinical parameters of 167 adult patients with urolithiasis. Patients and Methods: Cross-sectional, descriptive, retrospective study conducted in the urology department of Brazzaville University Hospital over a period of five years. We studied sociodemographic, therapeutic and evolutive. Results: During the study period 167 patients were treated for urolithiasis out of 2236 patients, a hospital frequency of 7.46%. The sex ratio M/F was 1.49. The average age of the patients was 42.05 years. They were overweight and/or obese in 53% of cases. Workers accounted for 46.53% of cases, with a low socio-economic level (42.5%) and a lower level of education (68.31%). There was a high percentage of complications, dominated by hydronephrosis (66.33%) and urinary tract infection (59.4%). The treatment was surgical in the majority of cases or 74.8%. Thirty-three patients had a lithiasis recurrence, a frequency of 19.7%. Conclusion: Urolithiasis is common. Being overweight is the most found risk factor. Lithiasis recurrence affects nearly one in five patients.

关键词： Urolithiasis Epidemiology Brazzaville

Advanced Prostate Cancer: A Case Report

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Open Journal of Urology 2019年第1期9卷 11-18页

作者： A. S. Ondziel Opara A. M. Ondongo Atipo A. W. S. Odzébé R. B. banga mouss B. Lebweze P. A. Bouya Service d’urologie-andrologie CHU de Brazzaville Brazzaville Congo

There are few reported cases in the prostate adenocarcinoma literature with locoregional extension and normal prostate-specific antigen (PSA). We present the case of a patient with prostate adenocarcinoma and metastases with PSA values within the normal range, despite evidence of clinical and radiological progression of the disease. This is a 72-year-old patient presenting with a dysectatic syndrome in which there is a budding ulceration of the glans, an induration of the corpora cavernosa and whose rectal examination has objectified a malignant prostate. PSA was assayed at 3.47 ng/ml;prostatic biopsy and magnetic resonance imaging (MRI) revealed prostate cancer with extension to the urethral, cavernous and rectal areas. Hormone therapy was instituted and the course after two months was marked by the occurrence of several episodes of anemia treated by blood transfusion.

关键词： Prostatic Adenocarcinoma Penile Urethra Rectum

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 effect

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