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A Panorama of the Urological Diseases at the Former Military Teaching Hospital of Cotonou

Open Journal of Urology 2023年第5期13卷 143-150页

作者： jean Sossa Lionelle Fanou Yao Félicien Hounto Dodji Magloire Inès Yevi fred jean-martin hodonou Déjinnin Josué Georges Avakoudjo Clinique Universitaire d’Urologie-Andrologie (CUUA) Centre National Hospitalier et Universitaire Hubert Koutoucou Maga (CNHU-HKM) Cotonou Benin

Background: Urological care has been advancing quickly over the last ten years in Benin. In order to conveniently support that trend towards better urological care standards, decision-makers need sound data on urological diseases in the country. Objective: To determine the prevalence of urological diseases in the former Military Teaching Hospital of Cotonou. Patients and Method: We retrospectively collected the urological diseases that the institution had managed from January 2012 to December 2020. We used Excel© 2010 and SPSS© to analyze the collected data. Results: 4244 patients, i.e. 3717 males (87.58%) and 527 females (12.42%) were managed during the study period. The main diseases diagnosed were benign prostatic hyperplasia (32.61%, n = 1384), erectile dysfunction (10.44%, n = 443), chronic prostatitis (5.94%, n = 252), prostate cancer (4.03%, n = 171), and ejaculatory disorders (3.44%, n = 146). In patients ≤ 15 years, predominant diseases were peritoneal vaginal canal (15.9%, n = 43), circumcision (15.6%, n = 42), testicular dystopia (10.7%, n = 29), hydrocele (7.8%, n = 21), and hypospadias (5.6%, n = 15). Wilms tumor (1.9%, n = 5) was the first cancer, testicular (0.4%, n = 1) and para-testicular (0.4%, n = 1) tumors were the next. In patients > 15 and ≤40 years, the main diseases were infertility (14.1%, n = 189), chronic prostatitis (12.9%, n = 173), erectile dysfunction (10.1%, n = 135), ejaculatory disorders (6.2%, n = 83), genital infections (6.2%, n = 83) and urinary stone (4.9%, n = 66). The first cancer was kidney cancer (0.97%, n = 13) followed by bladder cancer (0.3%, n = 4) and testicular tumor (0.3%, n = 4). In patients >40 years, the most prevalent diseases were BPH (52.0%, n = 1370), erectile dysfunction (11.7%, n = 308), prostate cancer (6.5%, n = 171), inguinal hernia (5.1%, n = 134), and urinary stone (3.9%, n = 102). Prostate cancer is the first cancer;the next were bladder (0.95%, n = 25) and kidney (0.68%, n = 18) c

关键词： Urological Diseases Former Military Teaching Hospital of Cotonou

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Correlation of PSA Level and ISUP Grade Group with Scintigraphic Bone Metastases Detection in 36 Prostate Cancer Patients

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Open Journal of Urology 2023年第8期13卷 309-316页

Background: We need population-specific clinical features that can predict bone metastases as an affordable therapeutic decision-making tool in newly diagnosed prostate cancer patients as scintigraphy or positron emission tomography are not available and as no such study had ever been performed in our country. Objective: To determine biologic and pathologic criteria that can predict the scintigraphic detection of bone metastases in our prostate cancer patients. Patients and Method: We analyzed with student’s t test and logistic regression the PSA level, the ISUP grade and the scintigraphic data retrospectively collected in newly diagnosed prostate cancer patients. Results: In ten years, 36 prostate cancer patients were sent to the Korle Bu Teaching Hospital in Accra (Ghana) for bone scintigraphy (mean age = 63.9 years;55.6%, 19.4% and 25.0% ISUP grade ≤ 2, 3 or ≥4). Among 28 patients who had performed the bone scintigraphy, 6 (21.4%) presented bone metastases, 22 (78.6%) had no bone metastasis. The mean PSA level was 36.7ng/mL in the non-metastatic patients and 97.7 ng/mL in the metastatic patients. The difference in PSA level between the 2 groups was significative (p = 0.041). 63.6% of the non-metastatic cancers versus 16.7% of the metastatic cancers were ISUP grade 2 or less. Inversely, 36.4% of the non-metastatic cancers versus 83.3% of the metastatic cancers were ISUP grade 3 or more. The difference was significative in the ISUP grade 2 or less (p = 0.035), was significative in the ISUP grade group 3 or more (p = 0.035). Metastasis was more likely in prostate cancer patients with PSA equal 30 ng/mL or more and ISUP grade 3 or more (83.3%) than in prostate cancer patients with PSA less than 30 ng/mL and ISUP grade less than 3 (16.7%) [OR = 13.7;CI 95% (1.59;31.0);p = 0.035]. Conclusion: The scintigraphic detection of bone metastases is low in patients with PSA < 30 ng/mL and ISUP grade < 3. This can be helpful in curative therapy decision making for prostate canc

关键词： Metastasis Prostate Cancer Bone Scintigraphy

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Survival Rate and Factors Influencing It in Triptorelin-Castrated Metastatic Prostate Cancer Patients

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Open Journal of Urology 2024年第3期14卷 160-172页

作者： Sossa jean Vissoh Gilvias Yevi Dodji Magloire Inès hodonou fred Avakoudjo Déjinnin Josué Georges Centre National Hospitalier Universitaire Hubert Koutoucou Maga Cotonou Bénin

Background: Most newly diagnosed prostate cancers in Benin are metastatic diseases and patients are reluctant to undergo orchiectomy. Still, chemical androgen deprivation therapy is not always available and not every patient can afford it. Thus, it will be interesting to evaluate the results of that therapy in the country. Objective: To analyze the survival rate and factors influencing it in metastatic prostate cancer patients who underwent triptorelin-based androgen deprivation therapy at the former Military Teaching Hospital of Cotonou from January 1, 2012, to December 31, 2022. Patients and Method: Metastatic prostate cancer patients received intragluteal injections of triptorelin 11.25 mg every 3 months. We retrospectively collected follow-up data from the patients’ medical records. By means of the software StataTM version 15, we performed a descriptive analysis of qualitative data. We used Kaplan-Meir method to estimate the overall survival rate in the whole cohort and in specific subgroups of patients. We compared survival rates by using the log-rank test. Results: 68 metastatic prostate cancer patients aged 47-86 years (mean = 69.9) with initial PSA ranging from 24.25 to 6334 ng/mL (mean = 666.1) started triptorelin-based castration. The tumor grade in 21 (33.3%), 14 (22.2%), 15 (23.8), 8 (12.7%), and 5 (7.9%) patients was respectively ISUP grade groups 5, 4, 3, 2, and 1. 15 (22.1%), 4 (5.9%), 2 (2.9%), 1 (1.5%), 11 (16.2%), and 7 (10.3%) patients respectively had hypertension, diabetes mellitus, peptic ulcer, asthma, unilateral or bilateral hydronephrosis, and paralysis. The mean nadir PSA level was 22.5 ng/mL (range: 0.01-220.25). The mean time to nadir PSA level was 8.9 months (range: 3-57). The overall survival rate was 42.6%. There was no significant survival difference between age groups (p = 0.475), relating to the presence of diabetes or hypertension (p = 0.757) or to the presence of paralysis or hydronephrosis (p = 0.090). The initial PSA level exert

关键词： Metastatic Prostate Cancer Androgen Deprivation Therapy Overall Survival PSA Nadir

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Results of an Eight Year Long Practice of Saline Bipolar Transurethral Resection of Prostate

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Open Journal of Urology 2024年第4期14卷 189-196页

作者： Sossa jean Mangoue Moube Ariane Landry Yevi Dodji Inès Magloire hodonou fred Avakoudjo Déjinnin Josué Georges Centre National Hospitalier Universitaire Hubert Koutoucou Maga Cotonou Benin

Background: Open prostatectomy has long been the only prostatic bladder outlet obstruction’s surgery available in Benin. It is prone to postoperative bleeding and infections and is not suitable for prostate cancer-induced bladder outlet obstruction. Objective: To evaluate the first results of endoscopic surgery of prostatic bladder outlet obstruction in our environment. Patients and Method: We conducted an observational study of saline bipolar transurethral resection of prostate (B-TURP) at the former Military Teaching Hospital of Cotonou. We retrospectively collected the data from patients’ medical records from November 17, 2014, to September 7, 2022. We used Excel 2019 to make a descriptive analysis of the data. Results: Saline B-TURP was performed in 60 consecutive patients. Their mean age was 69.1 years (range: 48-85). The procedure was indicated in 22 (36.7%), 32 (53.3%), 3 (5%), and 3 (5%) patients, respectively for acute urinary retention, chronic urinary retention, obstructive renal failure, and unresponsiveness to alpha-blockers. 35 patients (58.3%) had prostate cancer (PCa). 25 patients (41.7) had benign prostate hyperplasia (BPH). No patient got a blood transfusion. The duration of postoperative hospitalization was 3 days (88.3%) to 5 days (11.7%). 5 patients (8.3%), i.e., 3 BPH and 2 prostate cancer patients got preoperative urinary tract infection. The causative bacteria were Escherichia coli in 3 patients (60%), Klebsiella pneumoniae in 2 patients (40%), and multi-resistant Acinetobacter as a metachronous infection to Escherichia coli in 1 patient (20%). All the infections were associated with indwelling Foley catheter. 7 patients (11.7%), i.e., 3 BPH and 4 prostate cancer patients, got a second resection to recover full spontaneous micturition. Prostate size was available in the medical record of 21 BPH patients and 15 prostate cancer patients. Prostate size ranged from 22 to 123 g with a mean value of 61.1 g in BPH patients, and from 34 to 180 g with

关键词： Saline B-TURP BPH Prostate Cancer

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Klingsor Syndrome: An Observation in a Patient with Schizophrenia

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Open Journal of Urology 2024年第5期14卷 346-351页

作者： Mbuya Musapudi Eric Ouake Hadidjatou Michel Agounkpe Yevi Dodji Magloire Inès hodonou fred martin Avakoudjo Josué Georges Dejinnin Department of Urology and Andrology Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Department of Surgery University Clinics of Lubumbashi Lubumbashi Democratic Republic of the Congo

Background: Klingsor syndrome refers to genital self-mutilation in man following delusional religious beliefs. Later, Schweitzer proposed expanding the term to include all psychotic disorders, drug and alcohol abuse. Apart from the noted hemorrhagic emergency and difficult surgical operation, there is a psychosocial impact, sexual and urinary complications (stenosis, urethral fistula) which make this pathology complex. Aim: The Aim of this study is to describe the clinical case of Klingsor syndrome and evaluate its management in light of the literature. Case Presentation: We report a rare case of genital self-mutilation in a 35-year-old man, non-compliant schizophrenic, received 04 days after the trauma and whose treatment consisted of remodeling of the penis stump and follow-up by psychiatrists. Conclusion: Klingsor syndrome is a rare but serious phenomenon. Its management remains complex, but it must be early and multidisciplinary.

关键词： Klingsor Syndrome Génital Self-Mutilation Schizophrenia

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Epidemiological Aspects of Female Urological Diseases, at the National University Teaching Hospital H. K. Maga of Cotonou from 2008 to 2017

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Open Journal of Urology 2018年第10期8卷 281-288页

作者： Dodji Magloire Ines Yevi Josue Dejennin Georges Avakoudjo Detondji fred jean-martin hodonou Yves Nsounfou Ngapna jean Sossa Gilles Natchagande Fouad Kolawole Yde Soumanou Michel Michael Agounkpe University Clinic of Urology-Andrology of the National University Teaching Hospital H.K.MAGA of Cotonou(CNHU-HKM) CotonouBenin

Most urological conditions are represented by male disorders. Analyzing certain epidemiological aspects of female urological disorders at the National University Teaching Hospital of Cotnou, will allow us objectively to have reliable data to optimize the urological management of women. Patients and Methods: This was a retrospective, analytical and descriptive study that was conducted at the CNHU-HKM over a 10-year period from January 2008 to December 2017 on the epidemiological aspects of female urological diseases from the study of patient records. The variable studied was: the age, the profession, the year of admission, the organ affected, and the type of pathology. The confidentiality of the data has been ensured. Results: Female urological disorders over 10 years accounted for 9.62% of all patients received in Urology Department. The age group greater than 50 years was the most common at 31.34%. Traders and housewives were the most numerous (39.93% and 14.55%). Bladder diseases were the most frequent (51.50), dominated by vesico-vaginal fistulas (29.85%). In addition to fistulas, tumoral affections were most prevalent at 27.99% followed by infectious diseases at 8.21%. The lithiasic affections were infrequent at 6.72%. Conclusion: Female urological conditions are infrequent but not negligible, dominated by vesico-vaginal fistulas and tumors in the context of developing countries. The specific evaluation of each pathology group can help optimize management.

关键词： Female Urological Diseases Vesico-Vaginal Fistulas Cotonou Benin

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Prevalence of Comorbidities in the Urological Patients at the Former Military Teaching Hospital of Cotonou

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Open Journal of Urology 2023年第11期13卷 476-483页

作者： Sossa jean Fanou Lionelle Hounto Yao Félicien Yevi Dodji Magloire Inès hodonou fred martin Avakoudjo Déjinnin Josué Georges Clinique Universitaire d’Urologie-Andrologie Centre National Hospitalier Universitaire Hubert Koutoucou Maga Cotonou Benin

Background: Comorbidities are additive diseases and care burdens in urological patients. Determining the epidemiologic profile of comorbidities in urological patients in our setting may help us to better the management of urological disease. Objective: To evaluate the prevalence of comorbidities in urological patients. Patient and Method: We collected comorbidity, urological disease and demographic data in all urological patients managed at the former Military Teaching Hospital of Cotonou from January 1, 2012, to December 31, 2020. We used the software R 4.2.2 to perform descriptive and bi-varied data analysis. Student’s t test was used to compare means. Results: The prevalence of comorbidities was 14.2%, i.e., 601 comorbidity-affected among 4242 patients. The comorbidities predominantly affected men: the sex ratio was 13:1. The presence of comorbidity was correlated with patients’ age (p < 0.001). The comorbidities observed in the 601 affected patients were hypertension (84.5%), diabetes (26.5%), asthma (2%), and heart failure (1.2%). Hypertension (p = 0.001) and asthma (p = 0.030) were correlated with age. No comorbidity was associated with gender. The comorbidities’ prevalence was highest in patients aged 40 - 80 years who presented urological diseases such as BPH (68.9%), Erectile dysfunction (ED) and ejaculatory disorders, overactive bladder (OAB) and neurogenic lower urinary tract dysfunction (LUTD), renal cyst (5%), inguinal hernia (4.2%), urinary stones (2.8%), and prostate cancer (2.3%). Conclusion: The comorbidities’ prevalence was 14.2% in the urological patients. The main comorbidities were hypertension (84.5%) and diabetes mellitus (26.5%).

关键词： Comorbidity Urological Patients Prevalence

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The Impact of Body Mass on Male Fertility in a Cohort of 127 Patients

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Open Journal of Urology 2023年第11期13卷 469-475页

作者： Sossa jean Fanou Lionelle Kikpadé Joachim Hounto Yao Félicien Yevi Dodji Magloire Inès hodonou fred martin Avakoudjo Déjinnin Josué Georges Clinique Universitaire d’Urologie-Andrologie Centre National Hospitalier Universitaire Hubert Koutoucou Maga Cotonou Benin

Background: Aromatase and leptin are two adipose tissue cytokines. The former converts androgens into estrogens and stimulates adipogenesis. The latter cannot fully stimulate GnRH release as its hypothalamic receptors are reduced in obese men. Thus, obesity which is associated with an adipose tissue increment can interfere with male fertility. Objective: We aim to study the correlation between the body mass index (BMI) of an individual and the quality of semen he produces. Patients and Method: By means of the software R 4.2.1 we performed a retrospective analysis of the relationship between the BMI and the semen alterations in the patients managed at the former Military Teaching Hospital of Cotonou from October 1, 2017, to September 30, 2022: a bi-varied analysis and Fischer’s exact test (significance threshold 5%, confidence interval 95%) followed by a logistic regression when a non-significant p-value is below 0.20. Results: 127 males managed for infertility (mean age = 36.2 years) were recorded, including 11.1% obese (BMI > 30 kg/m2) and 36.5% overweighted (25 kg/m2 2). The most frequent semen alterations were: oligoasthenospermia (27.8%), asthenospermia (22.2%), oligoasthenoteratospermia (14.3%), azoospermia (13.5%) and asthenoteratospermia (9.5%). Bi-varied analysis showed no correlation between the BMI and the semen alterations (p-value ranged from 0.086 to 0.9) and no difference in semen alterations between patients with BMI below and above 25 kg/m2 (p-value ranged from 0.12 to 0.9). Logistic regression demonstrated that asthenoteratospermia were correlated with BMI ≥ 25 kg/m2 [OR = 2.1, 95% CI (1.50 - 2.70), p = 0.021]. Conclusion: Male obesity and overweight can trigger asthenoteratospermia.

关键词： Body Mass Index Male Infertility Semen Alterations

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Undescended Testis in Adult: Epidemiology and Therapeutic Aspects. About 23 Cases in HKM University Teaching Hospital of Cotonou

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Open Journal of Urology 2018年第7期8卷 206-213页

作者： Josué Avakoudjo fred hodonou Edoé Viyomé Sewa Yannick Tandje jean Sossa Magloire Yevi Michel Agounkpe Gilles Natchagande Urology Department of HKM National Teaching Hospital Cotonou Benin

Introduction: Undescended testis is a genital pathology of pediatric age. But it is not rare that the diagnosis of this pathology is made in adults, especially in low income countries with management problems as Benin Republic. The purpose of this study was to describe the epidemiology and therapeutic aspects of this congenital malformation in adults, in HKM University Teaching Hospital of Cotonou. Material and Method: It was a retrospective, cross-sectional and descriptive study, conducted from January 1, 2007 to December 31, 2016. Patient files served as data collecting support. All the patients aged 16 years and older were included in this study, treated and followed in the urology clinic department for undescended testis. Results: Twenty-three files were selected. The most represented age group was 16 to 20 years of age. The average consultation time from the observation of the anomaly was 213.6 months. The vacuity of the scrotum was the main reason for consultation. The absence of an intra-scrotal testis was the most clinical finding. The testis was found in the inguinal canal in 15 patients. Surgical re-positioning testis in scrotal location had been conducted for all patients and the open surgery was the only modality. Orchiectomy was performed in presence of atrophic testis. Any complication was reported in postoperative time. Later, two retractions of the testis and two testicular hypotrophies were seen. Semen control (spermograms) revealed persistence of azoospermia in three patients and astheno-zoospermia in another. Conclusion: Cryptorchidism is a pathology of the child but can still be seen in adults in our context. The main reason for consultation is the vacuity of scrotum but also paternity desire. Surgical lowering is the rule. In adults, its main purpose is the surveillance for the easy and early detection of a testicular tumor.

关键词： Undescended Testis Adult

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Ureterovesical Reimplantation in the Teaching Clinic of Urology and Andrology at HKM National Teaching Hospital of Cotonou: Indications, Techniques and Outcomes: About 36 Cases

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Open Journal of Urology 2018年第7期8卷 214-222页

作者： fred hodonou Josué Avakoudjo Edoé Viyomé Sewa Michel Agounkpe Gilles Natchagande jean Sossa Magloire Yevi Isidore Gandaho Fouad Soumanou Urology Department of HKM National Teaching Hospital Cotonou Benin

Introduction: The presence of an obstacle in upper urinary tract, threatens kidneys and therapeutic arsenal includes an ureterovesical reimplantation especially in the case of lower ureteral obstacles. Ureterovesical reimplantation (UVR) techniques are numerous with each of its advantages and disadvantages. In order to review indications, techniques and the outcomes of the ureterovesical reimplantation in our context of work, we made this study. Material and Method: It was a retrospective, transversal, descriptive and analytic study conducted over a period of 10 years, in the department of urology University Hospital Center Hubert Koutoukou Maga of Cotonou. Patients over 15 years of age who have had a ureterovesical relocation had been included. Results: Thirty-six files were selected. Ureterovesical relocations accounted for 1.8% of surgical procedures. The ligatures iatrogenic ureters and vesico-vaginal fistulas were the most frequently involved in 33.4% and 27.8% respectively. The ureterovesical reimplantation was performed without anti-reflux plasty at 36.1% of patients. The technique of Politano-Leadbetter had been most accomplished, in 82.6% of the cases in which anti-reflux plasty had been made. Suites had been simple in 63.9% of patients. Postoperative complications were dominated by parietal suppurations and vesicocutaneous fistulas in respectively 6 and 4 patients. Conclusion: Ureterovesical reimplantations are interventions that require from the urologist a perfect knowledge given their complexity and the emergency context in which one may be led to practice them. They answer to general principles that reduce operative morbidity.

关键词： Ureterovesical Reimplantation Indications Techniques

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