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Management of the Valves of the Posterior Urethra in urology

Open Journal of urology 2018年第5期8卷 166-170页

作者： Cyril Kamadjou Kimassoum Rimtebaye Divine Eyongeta Annie Kameni Justin Kamga Bertin Njinou medico-surgical center of urology and mini invasive surgery Douala Cameroon National General Referal Hospital N’Djamena Chad Regional Hospital Limbe Cameroon General Hospital Yaounde Cameroon

Aim: Describe the clinical, radiological and management of patients with posterior urethral valves. Materials and Methods: This was a retrospective descriptive study over a period going from January 2011 to December 2016, reviewing 12 cases of patients treated for valves of the urethra posterior to the medical surgical center of urology in Cameroon at Douala. The variables studied were clinical, paraclinical, therapeutic and evolutionary. Results: In 5 years, we had diagnosed and treated 12 cases of posterior urethral valves, an average of 2.4 per year. The average age of patients was 41.6 months with extrems of 3 and 156 months. The reason for consultation was dominated by urinary tract infections. Urethrocystography and echography were performed in all patients and allowed to objectify a bilateral ureterohydronephrosis, a diverticular bladder in 9 cases and 4 cases of vesico-ureteral reflux, including a grade 4 according to the classification of Cendron, 8 patients suffered from acute urinary failure. Renal scintigraphyrealised on 3 patients had as objective in 1 patient the existence of a disfunctioning kidney. The treatment consisted of an endoscopic incision of the valves (n = 8), a vesicostomy (n = 3) and an iterative urethral dilatation with double J catheter placement (n = 1). The evolution was favorable (n = 7), and 5 cases of death were recorded. Conclusion: The endoscopic incision is the gold-standard of the treatment of the valves of the posterior urethra. The vesicostomy is an alternative in the absence of adequate technical platform. Despite adequate support, the prognosis remains burdened with significant mortality.

关键词： Valves of the Urethra Vesicostomy Endoscopic Incision Renal Failure

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Epidemiological, Clinical and Therapeutic Profile of Obstructive Renal Failure

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Open Journal of urology 2018年第4期8卷 89-92页

作者： Kimassoum Rimtebaye Cyril Kamadjou Divine Eyongeta Annie Kameni Justin Kamga Bertin Njinou National General Referal Hospital N’Djamena Chad medico-surgical center of urology and mini invasive surgery Douala Cameroon Regional Hospital Limbe Cameroon General Hospital Yaounde Cameroon

Aim: To describe the epidemiological, clinical, etiologic and therapeutic aspects of patients with acute obstructive renal failure at the Medical surgical center of urology (MSCU). Materials and methods: this was a descriptive retrospective study of 106 patient records treated for acute renal failure from January 2012 to December 2016. Patients came for spontaneous consultation or were referred. They had benefited from a clinical and paraclinical assessment at the end of which the diagnosis of acute renal failure was retained and then an effective management at the MSCU. The variables studies were clinical, paraclinical, therapeutic and progressive. The treatment included: hemodialysis, urinary diversion (suprapubic, urethrovesical and ureteral), trans-urethral resection of the prostate, trans-urethral resection of the bladder, nephrostomy, endoscopic incision of catheter valves, posterior urethra or laparoscopic nephroureterectomy as indicated. The emergency treatments consisted of removing the obstacle and the etiological treatment was done later. External follow-up consultation varied by etiology. Results: In 4 years we had treated 106 patients, a frequency of 26.5%. The average age was 47.83 years with extreme of 2 and 80 years old. The sex ratio was 68 men for 38 women. The mean serum creatinine level was 37.8 mg/l (335 μmol/l). The etiologies were: prostatic pathologies (n = 38), lithiasic pathologies (n = 20) and gynecological pathologies (n = 18). The treatments were: endoscopic resection of prostate (n = 24), bladder (n = 6), posterior urethral valves (n = 4), JJ probe (n = 27) and nephrostomy (n = 23). The result was good (normalization of creatinine serum) in 79 patients, the persistence of elevated serum creatinine was observed in 4 patients and 18 patients died. Conclusion: Acute obstructive renal failure is a common diagnosis in our exercise setting at MSCU where it can be managed with respect to our technical platform.

关键词： Renal Failure Nephrostomy Creatinine Endoscopic Resection

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Diagnosis and Management of Prostate Cancer in urology

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Open Journal of urology 2018年第5期8卷 161-165页

Introduction: Describe the diagnostic approach and management of prostate cancer at the medico-surgical center of urology in Douala, Cameroon. Materials and methods: This was a descriptive retrospective study reviewing 100 patient’s records suffering of prostate cancer from January 2011 to December 2015. The studied variables were clinical, paraclinical and therapeutic. Results: The mean age was 65 years with extrems of 50 and 85. Rectal examination was suggestive in 63 cases. 7 patients had a family history. The average PSA rate was 43.23 ng/ml. Histology has concluded to an adenocarcinoma in all patients. The gleason score was equal or greater than to 7 for 53 patients (53%). The extended assessment revealed distant metastasis for 43 patients. The treatment was: surveillance (n = 33), total laparoscopic radical prostatectomy (n = 24), surgical hormone therapy (n = 10), medical hormone therapy (n = 28) and chemotherapy coupled with hormone therapy (n = 5). Conclusion: Prostate cancer is common in Douala;its diagnosis is made late. Radical treatment is possible for localized cancers, hence the interest of early detection.

关键词： Prostate Cancer Adenocarcinoma Prostatectomy Hormone Therapy

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Endoscopic Management of Bladder Stones: Initial Experience at a Single center in Cameroon

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Open Journal of urology 2022年第5期12卷 276-285页

作者： Cyril Kamadjou Annie Kameni Herve Moby Dolly Bilonda Kolela Achille Mbassi Fru Angwafor medico-surgical center of urology and mini-invasive surgery Douala Cameroon Department of surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Medical and Technology Institute Yaoundé Cameroon Coordinator of the urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Purpose: This study aimed to evaluate the efficacy and safety of endoscopic lithotripsy with the lithoclast (EMS, Switzerland) and laser Holmium YAG in the management of bladder calculi. Materials and methods: This was a retrospective study carried out from January 2013 to December 2019 on 32 patients with bladder calculi. All the patients underwent either Lithoclast or Laser lithotripsy using a 22F Storz cystoscope at the Centre medico-chirugicale d’urologie in Douala, Cameroon. Data on patients’ ages, clinical symptoms, stone sizes, type of lithotripsy, surgery duration, and results of lithotripsy were collected and analyzed using Epi info 7. Results: We recruited 32 participants (24 men and 8 women) with a median age of 41.28 [22 - 68] years into this study. In 9 (28.12%) participants, macroscopic hematuria was the main presenting complaint, followed by lower urinary tract symptoms in 8 (25%) patients. A cystoscopy was performed in 17 (53.12%) patients to confirm the diagnosis of a bladder stone, and ultrasonography of the upper urinary tract was performed in 29 (90.6%) cases to certify the absence of another stone. Lithoclast EMS was used to manage the stones in 23 (71.87%) patients while laser lithotripsy was used in 9 (28.13%). A dormia basket was used to remove stone fragments in 10 (31.25%) patients. The mean surgery duration was 33.59 ± 14.2 minutes, and the bladder stones were successfully managed in all the participants of this study. Minor complications such as pain during micturition were found in 28 (87.37%) patients, with complete resolution occurring two weeks after surgery. Conclusion: Endoscopy with lithotripsy is a safe and effective method of management of bladder stones. This technique is also associated with short surgical procedures and postoperative hospitalization periods. We believe that it is an excellent treatment modality in the management of bladder stones.

关键词： Bladder Stone Lithotripsy mini-invasive surgery Dormia Basket

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Laparoscopic Transperitoneal Pyeloplasty for Ureteropelvic Junction Obstruction: Preliminary Results from 26 Cases

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surgical Science 2023年第5期14卷 309-320页

作者： Cyril Kamadjou Divine Enoru Eyongeta Annie Kameni Wadeu Patrick Fotso Gwabap Bertin Njinou Ngninkeu Edouard Hervé Moby medico surgical Centre of urology and mini invasive surgery Douala Cameroon Department of surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of surgery Faculty of Health and Sciences University of Buea Buea Cameroon Clinic of Aeroport Douala Cameroon

Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Kuss-Anderson technique. Because of the minimally invasive nature of the laparoscopic approach, it has become the approach of choice for the management of this pathology. We present the results of laparoscopic transperitoneal pyeloplasty used in the management of PUJS. Materials and Methods: This was a retrospective study from 2015 to 2020, including 26 patients who underwent laparoscopic transperitoneal pyeloplasty for PUJS. Results: Twenty-six patients, including 18 (69.2%) men and 6 (30.8%) women, with a mean age of 35.42 ± 13.62 years, were treated. Renal colic was the primary symptom in the majority of the cases (22, 84.6%)). The diagnosis was confirmed in all patients through an abdominal CT scan, which revealed that all 26 patients had hydronephrosis. Half of the patients (50.0%) were classified as Valayer-Cendron Type II, and eight (30.8%) patients had associated stones. Seventeen (65.4%) patients had pathologies on the left side, and all patients were treated using the Kuss-Anderson technique with a median operating time of 108.5 (90.0 - 136.0) minutes. The uncrossing of lower pole vessels was performed in 10 patients. The average duration of hospitalisation was 2.23 ± 0.82 days. No conversion was observed, and after an average follow-up of 53.69 days, the success rate was 92.3%. Conclusion: Laparoscopic pyeloplasty is a minimally invasive technique of choice for the treatment of pyelo-ureteral junction obstruction. It is dependable, repeatable, and produces good functional outcomes that are equal to those of traditional surgery.

关键词： Pyelo-Ureteral Junction Lower Pole Vessel Pyeloplasty Double J Stent

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Transperitoneal Laparoscopic Nephrectomy for Non-Functional Kidneys: A Report of 25 Cases

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surgical Science 2022年第10期13卷 460-470页

作者： Cyril Kamadjou Emmanuel Muhawenimana Innocent Nzeyimana Achille Mbassi Bertin Njinou Ngninkeu Fru Angwafo medico surgical center of urology and mini invasive surgery Douala Cameroon Department of surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Kigali University Teaching Hospital Kigali Rwanda Medical Technology Institute Yaounde Cameroon Gynaeco Obstetric and Pediatric Hospital Yaounde Cameroon

Background and Aim: Ever since the first-ever laparoscopic nephrectomy performed in 1991 by Clayman, laparoscopy has become the technique of choice for benign renal pathologies and also for cancerous lesions. In this paper, we present and evaluate the results of laparoscopic nephrectomy carried out on patients with non-functional kidneys at the Centre medico-chirugical d’urologie in Douala, Cameroon. Materials and Methods: This was a retrospective study carried out from 2016 to 2020. We included 25 patients with non-functional kidneys who underwent transperitoneal laparoscopic nephrectomy. Results: We included 25 patients (15 males and 10 females) with a mean age of 32.80 ± 9.76 years. Twenty (80%) patients presented with low back pain, four (16%) presented with acute pyelonephritis, and one (4%) presented with both low back pain and hematuria. The right kidney was damaged in 10 (40%) patients and the left kidney in 15 (60%) patients. The kidney failure requiring nephrectomy was due to stones in 16 (64%) patients and upper pyeloureteric junction obstruction in nine (36%) patients. The mean surgery duration was 111.08 ± 31.95 minutes. The median perioperative blood loss was 100 [70 - 120] ml. Percutaneous drainage was required in 13 (52%) patients. Only two (8%) patients developed postoperative complications. The mean follow-up duration was 64 ± 24.48 days. All patients survived the surgical intervention. Conclusion: Laparoscopic nephrectomy is a mini-invasive technique that is suitable for the surgical removal of non-functional kidneys due to either ureteropelvic junction obstruction or massive kidney stones.

关键词： Pelvic Calculi Laparoscopy Nephrectomy Pyeloureteric Junction Obstruction

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Transperitoneal Laparoscopic Cystoprostatectomy for Muscle invasive Bladder Cancer: Results and Oncologic Outcomes in a Single center in Douala Cameroon

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surgical Science 2022年第11期13卷 529-540页

作者： Cyril Kamadjou Divine Enoru Eyongeta Annie Wadeu Kameni Herve Moby Mpah Justin Kamga Bertin Njinou Ngninkeu Fru Angwafo medico surgical center of urology and mini invasive surgery Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences Department of Surgery and Specialities University of Douala Douala Cameroon Regional Hospital Limbe Limbe Cameroon General Hospital Yaounde Yaounde Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon

Background and Aim: Radical cystectomy is the treatment of choice for muscle-invasive bladder cancer. Although open surgery is currently the gold standard for this procedure, it can also be done via laparoscopy. We aimed to evaluate the oncologic results and the place of laparoscopic cystectomy in the management of bladder cancer in a single urology center in Douala, Cameroon. Patients and Methods: This is a prospective, single-center study carried out from 2015 to 2019. We included 12 patients (ten men and two women) with bladder cancer who underwent total radical laparoscopic transperitoneal cystectomy with ilio-obturator lymph node dissection. Data on patients’ demographic characteristics, pre-operative and postoperative clinical parameters and workup results, and surgical outcomes were collected to determine the overall survival using a Kaplan-Meier curve. Results: We recruited ten men and two women with a median age of 61.5 [52.8 - 68.5] years. The mean tumor diameter was 3.75 ± 1.06 cm. Three (25%) patients received adjuvant chemotherapy while eight did not. The mean surgery duration was 242 ± 45.85 minutes. Blood vessels and nerves were preserved in four (33.33%) patients during surgery. Transitional cell carcinoma was found in 10 (83.33%) patients while epidermoid carcinoma was found in two (16.67%) patients. Metastasis occurred in four (33.33%) patients while the tumor recurred in two (16.67%) patients who later died. Bricker’s ileal conduit urinary diversion was performed in 10 (83.33%) patients while the Studer neobladder was used in two (16.67%) patients. The mean duration of hospitalization was 6 ± 1.48 days. Only one patient (8.33%) developed a postoperative complication. Six (50%) of the patients died while six survived. The median overall survival was 486 days and the five-year overall survival rate was 46.47%. Conclusion: Laparoscopic cystectomy is a mini-invasive technique associated with good cancer control. When performed by well-trained staff us

关键词： Laparoscopic Radical Cystectomy Bladder Cancer Overall Survival Urinary Diversion

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Prostate Cancer: Risk Factors and Outcome Indicators

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surgical Science 2022年第8期13卷 381-400页

作者： Cyril Kamadjou Annie Kameni Wadeu Jerry Kuitche Achille Mbassi Justin Kamga Fru Angwafo medico surgical center of urology and mini invasive surgery Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences Department of Surgery and Specialties University of Douala Douala Cameroon Yaoundé Medical and Technology Institute Yaoundé Cameroon Yaoundé General Hospital Yaoundé Cameroon Coordinator urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background: Prostate cancer, which is the second most frequent cancer diagnosis made in men, more commonly occurs in the elderly. This disease is often diagnosed late in resource-limited settings, which results in people having advanced forms of the disease and a poor prognosis. This study aimed to identify factors indicative of prostate cancer aggressivity and a poor prognosis in patients with prostate cancer at a single center in Douala, Cameroon. Methods: We performed a retrospective study from 2015 to 2020 at the Centre medico-chirugical d’urologie in Douala, Cameroon, in which we included 203 patients aged 41 years to 85 years who had prostate cancer diagnosed via histopathology after either prostate biopsyor laparoscopic prostatectomy. Epi-info 7 was used for data analysis and logistic regression analyses were performed to identify factors associated with prostate cancer aggressivity and patients’ outcomes (survival or mortality). Results: The mean age of our study participants was 64.76 ± 7.48 years. Ten patients had a contributive family history of prostate cancer. The patients presented with lower urinary tract symptoms in 61.58% of cases. All patients had serum prostate-specific antigen (PSA) levels of >4 ng/ml, 100 patients were anemic, and 36 patients had aggressive forms of the disease. Eighty-eight patients had remarkable digital rectal examination (DRE) findings. The median prostate volume, as determined via transrectal ultrasonography (TRUS), was 59 [43 - 80] ml. Fifty-nine patients had abnormal prostate echostructures, and 33 patients died during follow-up. The presence of paraplegia and the practice of professions requiring unskilled labor were significantly associated with aggressive prostate cancer. The presence of lymphoedema, abnormal DRE findings, anemia, enlarged prostate glands (prostate volume >50 ml), and abnormal prostatic echostructures were significantly associated with both prostate cancer aggressivity and patients’ outcomes. Conclusio

关键词： Aggressive Prostate Cancer Early Diagnosis Transrectal Ultrasonography Prostate Biopsy Prognosis

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Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

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Asian Journal of urology 2024年第2期11卷 271-279页

作者： Andrea Cocci Marta Pezzoli Fernando Bianco Franco Blefari Pierluigi Bove Francois Cornud Gaetano De Rienzo Paolo Destefanis Danilo Di Trapani Alessandro Giacobbe Luca Giovanessi Antonino Laganà Giovanni Lughezzani Guglielmo Manenti Gianluca Muto Gianluigi Patelli Novello Pinzi Stefano Regusci Giorgio I.Russo Juan I.M.Salamanca Matteo Salvi Luigi Silvestri Fabrizio Verweij Eric Walser Riccardo GBertolo Valerio Iacovelli Alessandro Bertaccini Debora Marchiori Hugo Davila Pasquale Ditonno Paolo Gontero Gennaro Iapicca Theo M De Reijke Vito Ricapito Pierluca Pellegrini Andrea Minervini Sergio Serni Francesco Sessa Department of urology Careggi HospitalUniversity of FlorenceFlorenceItaly urology Section University of FlorenceFlorenceItaly Urological Research Network MiamiFLUSA urology Section Prato HospitalPratoItaly Torvergata Oncoscience Research Centre of Excellence TORDepartment of Experimental MedicineUniversity of Rome Tor VergataRomeItaly Department of urology San Carlo di Nancy HospitalRomeItaly Department of Radiology Hôpital CochinParis Descartes UniversityParisFrance urology and Andrology Unit II Department of Emergency and Organ TransplantationUniversity of BariBariItaly Unit of urology Cittàdella Salute e della Scienza HospitalUniversity of TurinTurinItaly urology Unit Buccheri La Ferla Fatebenefratelli HospitalPalermoItaly Department of urology Humanitas Gradenigo HospitalTurinItaly urology Unit Surgical DepartmentFondazione Poliambulanza Istituto OspedalieroBresciaItaly Departement of urology “S.Giovanni Evangelista”HospitalTivoliItaly Humanitas Clinical and Research centereIRCCS Department of UrologyRozzanoItaly Department of Biomedical Sciences Humanitas UniversityPieve EmanueleItaly Department of Biomedicine and Prevention University of Rome“Tor Vergata”RomeItaly Department of Diagnostic Imaging and Interventional Radiology University of Rome“Tor Vergata”RomeItaly Department of Interventional Radiology Pesenti-Fenaroli Hospital-ASST Bergamo EstAlzano LombardoItaly Department of urology University of SienaSienaItaly Swiss International Prostate center GenevaSwitzerland Clinique Générale Beaulieu GenevaSwitzerland Department of urology University of CataniaItaly Department of urology Puerta de Hierro-Majadahonda University HospitalMadridSpain Lyx Institute of urology Universidad Francisco de VitoriaMadridSpain Department of medico-surgical Sciences and Biotechnologies Sapienza University of RomeFaculty of Pharmacy and MedicineUrology Unit ICOTLatinaItaly Department of urology European Institute of Oncology(IEO)IRCCSMilanItaly Department of Radiology D

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus ***: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and ***: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from 80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading t

关键词： Transperineal laser ablation Prostatecancer Benignprostatic hyperplasia Delphi consensus

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Laparoscopic Pyelolithotomy: Initial Experience with 62 Patients

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Open Journal of urology 2022年第1期12卷 74-82页

作者： Cyril Kamadjou Annie Kameni Dolly Bilonda Kolela Bertin Njinou Ngninkeu Fru Angwafor Medical and surgical center of urology Douala Cameroon Department of surgery and Specialities Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Coordinator urology Residency Program Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon

Objective: To evaluate the role of the laparoscopic approach in the management of pelvic calculi in a urology centre in Douala, Cameroon. Materials and Methods: This was a retrospective study carried out from 2014 to 2019 involving 62 patients with calculi at the renal pelvis managed through laparoscopic pyelolithotomy. Results: We recruited 62 patients (38 men and 24 women) with a median age of 36 [25 - 48] years. Nephritic colic was the most frequently encountered presenting complaint (92% of cases). In 56.45% of cases, the stone was on the left side of the body. Twelve patients had kidney acute failure at the time of diagnosis. Five patients received antibiotics for urinary tract infections before the operation. Before surgery, eight double J stents were placed in 8 patients;in five because of urinary tract infection and in three because of nephritic colic. In all the cases, the definitive diagnosis was made using abdominal CT scans. The median size of the calculi was 22 [17 - 28] mm. Dilatation of the pyelocaliceal cavity was noticed in all the patients. The median surgery duration was 100 [90 - 120] minutes. Drainage of the urinary tract using a double J stent was performed in all the patients, whereas percutaneous drainage was performed only in 9.67% of cases. There was no case of conversion to open surgery. Control ultrasound performed one month after the removal of the double J stent did not reveal any residual stones in the pyelocaliceal cavities. Conclusion: Laparoscopic pyelolithotomy is a mini-invasive technique that is adequate for the management of voluminous pelvic calculi.

关键词： Laparoscopic Pyelolithotomy Pelvic Calculi Cameroon

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