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Prostatic Adenomectomy and Comorbidities: Frequency and Management at the Urology Department of the Ignace Deen National Hospital in Conakry

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Open Journal of Urology 2024年第4期14卷 217-226页

作者： Demba Cisse Alpha Oumar Barry Morlaye Fatoumata Bangoura Alimou Diallo mamadou Dian bah Youssouf Keita Daouda Kanté Thierno mamadou Oury Diallo mamadou Bissiriou bah mamadou diawo bah Abdoulaye Bobo Diallo Oumar Raphiou bah Maitre-Assistant à la Facult&#233 des Sciences et Techniques de la Sant&#233 Universit&#233 Gamal Abdel Nasser de Conakry Conakry Guin&#233e

Goal: To determine the type of comorbidity and highlight the complications of adenomectomy and comorbidities. Material and Methods: This is a prospective, descriptive, cross-sectional study lasting six (6) months, from July 1, 2022 to December 31, 2022. Patients with BPH on comorbidity condition taken care of during the study period AND have agreed to participate in the study. Results: During our study, 49 cases of benign prostatic hypertrophy with comorbidities were collected, representing a frequency of 29%. The average age ranges for the patients were 43 - 70 years. The age group most affected was 70 to 79 years old (38.80%). Nocturnal urinary frequency was the main reason for consultation present in all our patients. The most frequent comorbidity was hypertension, i.e. 83.70%. The PSA rate between 4 and 10 was the most represented, i.e. 42.86%. The prostate volume was between 61 and 100 ml in 40.82% of patients. Histology showed that it was a benign adenomatous hypertrophy of the prostate in 85.70% and a prostatic adenomyoma in 14.29%. Trans-bladder adenomectomy alone was the most performed technique, i.e. 49%, followed by trans urethral resection of the prostate, i.e. 38.80%. Retention of urine after removal of the catheter was the most observed complication, i.e. 12.20%. Conclusion: Benign prostatic hypertrophy with comorbidities constitutes a frequent association. Because their presence can affect effectiveness and lead to complications.

关键词： Prostatic Hypertrophy Comorbidities Conakry University Hospital

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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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Iatrogenic Urethral Stenoses: Epidemiological Aspects Clinics and Therapeutic in the Urology Department of the National Hospital of Conakry

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Open Journal of Urology 2023年第1期13卷 36-47页

作者： Demba Cisse Youssouf Keita Fode Oumar Keita mamadou II Barry Alimou Diallo Thierno mamadou Oury Diallo mamadou diawo bah mamadou Bissiriou bah Alpha Oumar Barry Daouda Kante Ibrahima bah Oumar Raphiou bah The Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea

The aim is to highlight the epidemiological, clinical and therapeutic aspects of iatrogenic urethral strictures. Methodology: This was a retrospective study, descriptive type, 6 years from January 1st 2012, to December 31st 2017 carried out in the Urology-Andrology department of the National Hospital Ignace Deen of Conakry. All records of patients carrying the Diagnosis of iatrogenic urethral stricture were included in this study. Results: We collected 30 cases of iatrogenic urethral stricture, with a frequency of 2.5%. The average age of the patients was 62.33 years. The most affected age group is from 71 to 80 years (33.33%). Dysuria was the main reason for consultation. Retrograde urethrocystography plus voiding cystourethrography (RUC-VCU) allowed us to make the diagnosis. The treatment was essentially surgical and several techniques were used. Endoscopic internal urethrotomy alone was the most performed surgical technique, followed by segmental uretrectomy associated with end-to-end urethrography. Conclusion: Iatrogenic urethral stricture is easy to diagnose but difficult to manage due to the frequency of recurrences. Improving the quality of care, in particular urethral catheterizations and transurethral endoscopic maneuvers, makes it possible to prevent it.

关键词： Stenosis Urethra Iatrogenic Conakry

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Management of the Torsion of Spermatic Cord in the Urology-Andrology Department of the Ignace Deen National Hospital in Conakry

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Open Journal of Urology 2023年第10期13卷 399-406页

作者： Thierno mamadou Oury Diallo mamadou Bissiriou bah mamadou diawo bah Boris Amougou Daouda Kanté Alimou Diallo Demba Cissé Abdoul Haqq bah L’Imam mamadou Dian Oury Diallo Abdoulaye Bobo Diallo Oumar Raphiou bah Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Torsion of the spermatic cord is an emergency whose delay in treatment conditions the functional prognosis of the testicle. The aim of this study was to analyze the management of spermatic cord torsion in the Urology Andrology Department of the Ignace Deen National Hospital in Conakry. Material and methods: This was a ten-year retrospective descriptive study from January 1, 2012 to December 31, 2021. It involved all patients admitted for torsion of the spermatic cord, confirmed at surgical exploration. Results: We identified 21 cases of torsion of the spermatic cord. The mean age of the patients was 17.9 ± 4.4 years. The average consultation time was 19.2 ± 21.4 hours with extremes of [2 h and 98 h]. Only 6 patients (28.6%) consulted before the sixth hour. All patients presented with scrotal swelling. At scrototomy, all torsions were intravaginal with two turns of spiral in 13 cases and three turns in 8 cases. Orchiectomy followed by contralateral orchidopexy was performed in 6 cases. In the other cases, bilateral orchidopexy was performed after detorsion. The average hospital stay was 4.5 days. We recorded 4 cases of testicular atrophy after orchidopexy. Conclusion: Spermatic cord torsion is an infrequent emergency in our department. The delay in consultation remains the main predictive factor of testicular necrosis. Emergency exploratory scrotomy should be the rule.

关键词： Spermatic Cord Torsion Delay in Consultation Orchidopexy Orchiectomy Testicular Atrophy

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Profile of the Infertile Man at the University Hospital of Conakry (Guinea)

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Open Journal of Urology 2023年第7期13卷 223-237页

作者： bah mamadou Bissiriou Kanté Daouda Sow Thierno Amadou Oury Thierno mamadou Oury Diallo Koulalerou Aimon Axel Cédric Cissé Demba mamadou diawo bah Barry mamadou Dian Thierno Oumar Diallo Diallo Alimou Ibrahima bah Abdoulaye Bobo Diallo Oumar Raphiou bah Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Urology Department CHU of Conakry Guinea

Introduction: Male infertility is defined as the inability of a man to impregnate a woman after 12 months of regular sexual intercourse without contraception. Objective: To improve the state of knowledge on the profile of the infertile man in Guinea. Methodology: We conducted a prospective, descriptive study over a period of 6 months from October 1st, 2020 to March 31st, 2021. Results: We collected an overall number of 71 patients seen onroutine consultation for infertility. They had a mean age of 36.4 years. More than half of our patients were monogamous (79% of cases). Civil servants were the most affected with 38.02% of cases. Primary infertility was dominant in 65% (n = 46) of cases. On clinical examination, varicocele was the most remarkable abnormality with 88.73% (n = 63) followed by testicular hypotrophy with 59.15% (n = 42). Azoospermia was the most frequent sperm abnormality with 22.54% (n = 16) followed by oligospermia with 15.49% (n = 11). Hormonal assessment based on FSH and LH was performed in 16 patients with azoospermia (22.53%). FSH elevation was associated with azoospermia in 6 patients, i.e. 8.45%, azoospermia associated with a normal FSH level accounting for 14.08% in our series. Conclusion: In our practice, male infertility is becoming more and more of a concern due to the increasing number of patients seeking treatment. The scarcity of a medical assistance for procreation unit alongside with more efficient diagnostic means constitutes a handicap for its management.

关键词： Male Infertility Varicocele Azoospermia Spermogram

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Surgical Treatment of Urological Complications of Gynecological and Obstetric Surgeries at the University Hospital of Conakry Guinea

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Open Journal of Urology 2015年第12期5卷 231-237页

作者： Abdoulaye Bobo Diallo Telly Sy Thierno mamadou Oury Diallo Alpha Boubacar bah Aboubacar Touré mamadou diawo bah mamadou Bobo Diallo Service d’Urologie-Andrologie CHU de Conakry Conakry Guinée Service de Gynécologie-Obstétrique CHU de Conakry Conakry Guinée Service de Chirurgie Générale CHU de Conakry Conakry Guinée

Objective: To analyze the management of urological complications of gynecologic and obstetric surgeries. Material and Methods: We retrospectively studied 39 patients hospitalized in the Department of Urology of the Conakry Teaching Hospital for urological complications of gynecological surgery, during 9 years. The epidemiological, diagnostic, surgical and outcome parameters have been analyzed. Results: The urological complications of gynecologic surgery represent 0.29% of admissions in the Department of Urology. The mean age was 31 years with extremes of 18 and 47 years. Etiological factors were dominated by caesarean section with 74.36% of cases. The main lesions observed were vesico-vaginal and uretero-vaginal fistulas respectively 43.6% and 41.2% of cases. The mean delay of diagnosis was 5 months (extreme: 7 days to 3 years). Urine leakage from the vagina was the main symptom. The surgical treatment consisted in 17 surgeries for vesico-vaginal fistulas, 16 surgeries for uretero-vesical reimplantation, 2 surgeries for termino terminal ureterorraphia, 2 surgeries for vesico-uterine fistulas and 1 surgery for hysterectomy. Healing was obtained in all ureteral injuries and we noted two cases of failure in vesico-vaginal fistula. Conclusion: urological complications of gynecologic surgery remain frequent. They are dominated by the vesico-vaginal and uretero-vaginal fistulas and the main etiology is caesarean section. The treatment is surgical in our context.

关键词： Lesions Bladder Ureter Treatment Surgery

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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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Vesicovaginal Fistulas: Anatomical Clinical and Surgical Aspects in the Conakry University Hospital Center

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Open Journal of Urology 2015年第12期5卷 224-230页

作者： Abdoulaye Bobo Diallo Thierno mamadou Oury Diallo Ibrahima bah mamadou diawo bah mamadou 2 Barry Daouda Kanté Oumar Raphiou bah Sékou Guirassy mamadou Bobo Diallo Urology and Andrology Unit University Teaching Hospital Conakry Conakry Guinée Service d’Urologie-Andrologie CHU Conakry Conakry Guinée

Objective: To analyze the management of VVF in the Service of Urology-Andrology Obstetrics and Gynecology of the University Hospital in Conakry. Materials and Methods: From January 2012 to December 2013, 152 patients with a mean age of 30 years (14 - 80 years) were hospitalized in the Departments of Urology-Andrology and Gynecology-Obstetrics of the Conakry University Hospital Center. Clinically fistulas were divided according to the classification of Benchekroun as single, complex and complicated. The fistulas were diagnosed after a minimum period of three months and the results were assessed with a mean follow-up of 7 months (range 3 to 10 months) according to the following criteria: complete healing, intermediate healing and failure. Results: Fistulas occur mainly in young multiparous women. The obstetric etiology was dominant (98%). Clinically, there were 30% simple fistulas, 46% complex fistulas and 24% of complicated fistulas. From a therapeutic standpoint, the treatment consisted of a single fistulorraphie (Chassar Moir) in 82% of cases and a fistulorraphie with interposition of healthy tissue in 18% of cases. After a mean follow-up of 7 months we obtained a healing in 62% of cases, a failure in 31% of cases and the results were intermediate in 7% of cases. Conclusion: It appears that the VVF represents a public health concern in Guinea and surgical treatment is technical difficult due to the higher frequency of complex fistulas.

关键词： Vesico-Vaginal Fistulas Epidemiology Treatment

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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 diagnostic and therapeutic arsenal is necessary to

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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