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Complications of Circumcision: Epidemiological, Anatomo-Clinical and Therapeutic Aspects

Open Journal of Urology 2023年第10期13卷 433-440页

作者： Aboubacar Traore Issa Thiam Ousmane Sow Modou Sene ndiath abdoulaye Sow Yaya Urology Department Regional Hospital of Saint-Louis Saint-Louis Senegal

Circumcision refers, in its most widespread form, to the total or partial removal of the foreskin, leaving the glans exposed. It is a ritual practice imposed by Mosaic law for Israelites, a tradition for Muslims, a rite of passage to adulthood for many people of Africa and the East. Circumcision is also a widely used therapeutic surgical procedure for a number of balanopreputial affections. The aim of this study was to list cases of circumcision complications received in a urological hospital (CHR Saint Louis) and to analyze their epidemiological, anatomo-clinical and therapeutic aspects. Patients and methods: This was a retrospective, descriptive study of circumcision complications, carried out in the urology department of the Saint Louis regional hospital in Senegal over a 5-year period (January 1, 2013 to December 31, 2017). Results: Thirty-three (33) complications of circumcision were collated. The mean age of patients was 7.63 years [9 months - 16 years]. Duration of time for Consultation varied according to the type of complication, with an average of 1.6 years [1 day - 10 years]. Penile granuloma accounted for 36.3% of the complications (n = 12), local infection for 30.3% (n = 10) and urethro-cutaneous fistula for 18.2% (n = 6). For six patients with urethro-cutaneous fistula, we performed urethro-cutaneous splitting in 5 patients, while the same complication necessitated urethroplasty in another patient. We noted five cases of verge plasty for verge granuloma, one glan reimplantation and one glan plasty for the two patients with glans amputation. Conclusion: Circumcision is a medical procedure widely practised throughout the world for medical, cultural and aesthetic reasons. In Africa, the lack of health coverage and the shortage of doctors explain why this surgical procedure is so common. In Senegal, circumcision is still carried out in the majority of cases by paramedical staff, which explains the high rate of complications.

关键词： Circumcision Complications Penile Fistula Glans Amputation

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High Urine Retention: Experience in a Series of Patients with Renal Failure Patients

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Open Journal of Urology 2024年第1期14卷 1-10页

作者： Cyrille Ze Ondo abdoulaye ndiath Amath Thiam Alioune Sarr Ndiaga Seck Ndour Ousmane Sow Babacar Sine Babacar Diao Alain Khassim Ndoye Urology Department Aristide Le Dantec Hospital Dakar Senegal Urology Department Ouakam Military Hospital Dakar Senegal

Purpose: High urinary retention (HUR) can negatively impact renal function. Our study aimed to present the epidemiological, diagnostic, and therapeutic aspects of HUR in a Senegalese academic hospital. Patients and Methods: We conducted a retrospective study of 70 patients with HUR associated with renal failure from January 2017 to December 2020. Parameters examined included: age, sex, coexisting conditions affecting renal function, clinical symptoms, diagnostic tests, causes of HUR, urinary diversion, and patient outcomes. Results: The average age was 66, with a majority of male patients (87%). Twenty-three patients had pre-existing medical conditions. Oligo-anuria was the most common reason for detecting HUR (70%). Half of the patients had an ECOG score ≥ 2. The mean creatinine level was 50.7 mg/l. Nineteen patients exhibited hydroelectrolytic disorders. Bacterial colonization was observed in 25 patients. Ultrasound and computed tomography were the most frequently performed imaging tests (100% and 62.8%, respectively). Sixty-seven patients had ureterohydronephrosis (UHN), with bilateral UHN in 88.6% of cases. Pelvic cancers (47.1%) were the primary cause of HUR, primarily bladder cancers (27.1%). Nephrostomy was the most common urinary drainage method (50%), particularly for obstructions due to pelvic cancer (88.6%). The majority of patients (52.8%) regained normal renal function after drainage. Nineteen deaths occurred among elderly patients with compromised general health. Conclusion: Urinary drainage significantly improved renal function for most patients. Pelvic cancer emerged as the leading cause of HUR. Nephrostomy was the predominant drainage method.

关键词： Kidney Urinary Retention Renal Failure Urinary Diversions Senegal

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Cure of Varicocele under Local Anesthesia: Impact on Sperm Parameters

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Open Journal of Urology 2024年第10期14卷 507-513页

作者： Babacar Sine Arsen Ngoie Mudiangombe Ndeye Aissatou Bagayogo Amath Thiam Omar Cissokho Moustaf Cheikh Ahmed abdoulaye ndiath Ibrahima Cisse Babacar Diao Khassim Ndoye Alain Urology Andrology Department of Military Hospital of Ouakam Dakar Senegal Urology Andrology Department of the Aristide Le Dantec Hospital Dakar Senegal

Introduction: Varicocele is one of the most frequent causes of infertility. There are several therapeutic modalities, namely surgery (open and laparoscopic) and conventional radiology. The aim of our study was to evaluate the impact of a varicocele cure under local anaesthesia on spermogram quality. Material and Methods: We conducted a retrospective descriptive study from 1 January 2022 to 31 December 2023 in the urology department of the Hôpital Militaire de Ouakam (HMO). The parameters studied were age, reasons for consultation, time to urology consultation, grade of varicocele, Doppler ultrasound and spermogram data before treatment and 3 months after treatment. Treatment consisted of bilateral subinguinal varicocelectomy under local anaesthetic. Data were entered and analysed using Excel software version 2021. Results: We studied 41 patients. The mean age of the patients was 35.3 ± 6.9 years, with extremes of 22 and 50 years. Thirty-eight of our patients (88.37%) were married. The most frequent reason for consultation was primary infertility (72.09%). 28 patients (68.3%) had a bilateral varicocele on ultrasound. Varicocele was associated with bilateral testicular hypotrophy in 13 patients (31.7%) and unilateral left testicular hypotrophy in 11 patients (26.8%). All patients underwent subinguinal varicocelectomy under local anaesthetic. Mean follow-up was 4.5 months. A clear statistically significant improvement was noted in sperm motility and concentration in postoperative spermograms, with normalisation of the spermogram in 15 (36.5%) of patients. Conclusion: The impact of varicocele on sperm parameters has been clearly established. There are various therapeutic methods for curing varicocele, including varicocelectomy under local anaesthetic, which, in addition to its undeniable economic advantages, can significantly improve sperm parameters in patients with varicocele and prevent their deterioration over time.

关键词： Varicocele Local Anesthesia Spermogram

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Positive Surgical Margins (PSM) after Open Retropubic Radical Prostatectomy: Evaluation of Patient Survival

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Open Journal of Urology 2021年第7期11卷 282-288页

作者： Babacar Sine abdoulaye ndiath Ndéye Aissatou Bagayogo Alioune Sarr Amath Thiam Cyrille Ze Ondo Ousmane Sow El Hadji Malick Diaw Moussa Séne Babou Sakho Cheikh Bécaye Gassama Ibrahima Ngom Yaya Sow Babacar Diao Alain Khassim Ndoye Urology Andrology Department of Aristide Le Dantec Hospital Dakar Sénégal Urology Andrology Department of Ouakam Military Hospital Dakar Sénégal

Background: Many patients who have had radical prostatectomy for prostate cancer may present with microscopic extraprostatic extension of the disease. Positive surgical margins are a common pathological finding in this subgroup of patients. To report the epidemiological, clinical and therapeutic aspects of PSM after radical prostatectomy (RP) and to evaluate the follow-up of patients. Patients and methods: A single-center retrospective descriptive study of patients who underwent radical prostatectomy between June 1, 2004 and December 31, 2019 was conducted. Patients who had radical prostatectomy with PSM on pathology report were included. The parameters studied were age, initial prostate specific antigen (PSA), Gleason and International Society of Uropathology (ISUP) scores, cTNM and pTNM stages, operative technique, PSA levels after surgery, adjuvant treatment and patient survival. Results: Eighty-six (86) radical prostatectomies were performed. PSM was found in 23 patients (26.7%). The mean age of the patients was 63.7 ± 6.1 years. The mean preoperative total PSA was 31.5 ng/mL (6.31 - 146 ng/mL). Prostate biopsy showed only prostatic adenocarcinoma. Thoracic-abdominopelvic CT was performed in all patients. Prostate cancers were found at the localized stage in 12 patients and locally advanced in 11 patients. A classification adjustment was obtained after pathological examination of the surgical specimen. The ISUP score 3 and 1 on the surgical specimen were in the majority with 9 and 7 patients respectively. After the recurrence, all patients who consented received hormone therapy, which was either medical with Goserelin and Triptorelin (7 patients) or surgical with testicular pulpectomy (1 patient). PSA was undetectable (Conclusion: RP with PSM is a fai

关键词： Prostate Cancer Surgical Margins Survival

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Diagnostic Rigid Urethrocystoscopy: Indications, Results and Pain Assessment

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Open Journal of Urology 2020年第8期10卷 239-244页

作者： Ousmane Sow abdoulaye ndiath Aboubacar Traore Alioune Sarr Babacar Sine Modou Ndiaye Yassin Sayerh Cyrille Ze Ondo Amath Thiam Ndiaga Seck Ndour El Hadj Malick Daw Ndeye Aissatou Bagayogo Yaya Sow Boubacar Fall Babacar Diao Papa Ahmed Fall Alain Khassim Ndoye Urology-Andrology Department Aristide Le Dantec Hospital Dakar Senegal Urology-Andrology Department De la Paix Hospital Ziguinchor Senegal Urology-Andrology Department Dalal Jamm Hospital Dakar Senegal

Background: Over the last 50 years, endourology has revolutionized urological practices worldwide. This is not so in many urological centers in West Africa. Although, some centers have made progress in the level of urological services that they offer;many of such centers provide rigid urethrocystoscopy services. Rigid urethrocystoscopy is an endoscopic examination that explores the urethra, bladder and prostate in men. Aims: We report the indications, results and pain assessment of rigid urethrocystoscopy in our center. Patients and Methods: We carried out a retrospective, descriptive, monocentric study in our center between January 2016 and June 2018. The study included all patients who had a rigid urethrocystoscopy under local anaesthesia. We studied the following parameters: sex, age, indications for the examination, outcomes and the pain assessment. Results: Five hundred and forty-one patients were included. The sex-ratio was 1.49. The mean age was 49.47 ± 18.48 years (12 years and 91 years). Lower urinary tract symptoms (29%) and hematuria (28%) were the most common indications. The rigid urethrocystoscopy was normal in 26.8% of patients. Bladder tumors (21.2%) were the most frequent lesions. In men, prostate tumors were more common (21%) followed by bladder tumors (17.9%), while in women, bladder tumors (26.3%) were predominant followed by cystopathy lesions (12.4%).The mean Simple Verbal Scale (SVS) score was 1.25 in women and 2.1 in men. Conclusion: Rigid urethrocystoscopy was relatively well tolerated by our patients. Hematuria was the primary indication and the main etiologies were bladder and prostate tumors.

关键词： Rigid Urethrocystoscopy Bladder Tumors Hematuria

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Hypospadias: Evaluation of Therapeutic Outcomes and Sexual Function in Adulthood in a University Hospital Setting

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Open Journal of Urology 2020年第9期10卷 245-252页

作者： El Hadji Malick Diaw Modou Ndiaye Ousmane Sow abdoulaye ndiath Alioune Sarr Boubacar Fall Babacar Sine Aboubacar Traore bdourahmane Ndong Cyrille Ze Ondo Amath Thiam Oumar Gaye Ndiaga Seck Ndour Ngor Mack Thiam Yaya Sow Babacar Diao Papa Ahmed Fall Alain Khassim Ndoye Urology-Andrology Department Aristide Le Dantec Hospital Dakar Senegal Urology-Andrology Department De la Paix Hospital Ziguinchor Senegal Departement of Surgery Gaston Berger University Saint-Louis Senegal Urology-Andrology Department Dalal Jamm Hospital Dakar Senegal

Background: Hypospadias is a congenital malformation resulting from hypoplasia of the tissues forming the ventral face of the penis. It is associated to variable degrees with an ectopic urethral meatus, a penis curvature and a sapper’s apron foreskin [1]. The incidence of this malformation varies from country to country. It is estimated at 1/300 male births in France and 0.26/ 1000 in Mexico [1]. In Senegal, the prevalence of this malformation is unknown. Hypospadias surgery has improved significantly in recent years due to a better understanding of the anatomy on the one hand and the improvement of the instruments used during surgery on the other (suture material, surgical magnification, urethral catheter of suitable size). In sub-Saharan Africa and particularly in Senegal, hypospadias surgery remains a challenge due to the unavailability of adequate equipment (lack of microsurgical instruments and surgical loupes). Objective: To evaluate the outcomes of the treatment of hypospadias by the different surgical techniques used in our center as well as their sexual function in adulthood. Patients and Methods: This is a retrospective study, including all patients operated for hypospadias between January 2009 and December 2017 in Urology-Andrology department of Aristide Le Dantec hospital. The studied parameters were: frequency, age, clinical and therapeutic aspects, and their sexual function in adulthood after treatment. The outcomes of the treatment were judged good or poor depending of the quality of penile straightening, the aesthetic appearance of the penis, the position of the urethral neo-meatus, the permeability of the urethra and the existence or not of fistula. The sexual function was assessed by the International Index of Erectile Function 15 (IIEF) score. Results: Fifty-five patients were included. The median age was 6 years (P25 = 2.8 and P75 = 13 year

关键词： Urogenital Malformation Penile Enlargement Urethroplasty Urethrocutaneous Fistula

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Metastatic Prostate Cancer under Androgen Deprivation Therapy: Factors Influencing Castration Resistance

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Open Journal of Urology 2020年第7期10卷 225-232页

作者： Modou Ndiaye Ousmane Sow Babacar Sine Omar Gaye Alioune Sarr abdoulaye ndiath Cyrille Ze Ondo Amath Thiam Ndeye Aissatou Bagayogo Samba Thiapato Faye Ndiaga Seck Ndour Aboubacar Traore Ngor Mack Thiam El Hadj Malick Diaw Yaya Sow Boubacar Fall Babacar Diao Alain Khassim Ndoye Urology-Andrology Department Aristide Le Dantec Hospital Dakar Senegal Urology-Andrology Department De la Paix Hospital Ziguinchor Senegal

Objective: To evaluate the factors predicting the time to progression to castration-resistant in metastatic prostate cancer under Androgen Deprivation Therapy (ADT) in our center. Patients and Methods: This is a retrospective, descriptive, analytical study in a single center over a period of 2 years. It has interest patients followed for metastasized prostate cancer under ADT. The parameters studied were: epidemiological, clinical, paraclinical, prostate specific antigen (PSA) nadir, time to nadir (TTN) and their link with the castration resistance. Results: The frequency of castration resistant prostate cancer was 28 patients per year. The mean age was 70.4 ± 7.9 years. An ECOG score ≥ 3 was more common as was the cT2c stage. The median of the initial total PSA was 489.6 ng/ml (203.3;1653.2). All patients had adenocarcinoma. The International Society of Urological Pathology (ISUP) 1 was more frequent. Bone metastases were more frequent. The medians of nadir, TTN and the castration resistance were 19.3 ng/ml (3.7;102.1), 5.5 months (3;9) and 11 months (6;15.3), respectively. The Eastern Cooperative Oncology Group (ECOG) score, clinical stage, metastatic site, the nadir and its TTN influenced the DSR. Age, lymph node involvement, initial total PSA and Gleason score did not influence the castration resistance. Conclusion: ADT should be initiated as soon as possible before an attack of general and/or clinical stage advanced to delay resistance. A drilling should be associated with this hormone therapy as much as possible because of its gain on resistance.

关键词： Cancer Prostate Androgen Deprivation Therapy Resistance Prognoses

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