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Evaluation of the Quality of Micturition in Patients Who Underwent Anastomotic Urethroplasty at the yaounde central hospital, Cameroon

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Open Journal of Urology 2024年第2期14卷 115-127页

作者： Achille Aurele Mbassi Landry Oriole Mbouche Junior Mekeme Mekeme Jean Crepin Eloundou Nkolo Bright Che Awondo Jean Cedrik Fouda Frantz Guy Epoupa Ngalle Cyril Kamadjou Pamela Anaba Laure Pierre Joseph Fouda Fru Forbuzshi III Angwafo Higher Institute of Medical Technology Yaounde Cameroon Higher Institute of Health Sciences Bangangte Cameroon Urology and Andrology Department Yaounde Central Hospital Yaounde Cameroon Department of Surgery and Subspecialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon yaounde Gynecology Obstetrics and Pediatric Hospital Yaounde Cameroon

Introduction: Radiological investigation which is the gold standard to perform following anastomotic urethroplasty in order to evaluate the quality of micturition is costly. In our context, due to financial limitations, reconstructive urologists prefer to use the uroflowmetry in order to assess the micturition post-surgery. Therefore, the objective of the study was to assess the quality of micturition using the uroflowmetry after anastomotic urethroplasty. Methodology: We conducted an 11-year retrospective review (1st January 2006-31st December 2017) and a cross-sectional descriptive observational study for a period of 8 months (November 2017-June 2018) at the Urology and Andrology Department of the yaounde central hospital (YCH) of patients who were diagnosed with urethral stenosis and underwent an anastomotic urethroplasty at the YCH. We excluded patients who had incomplete files, patients lost to follow-up and did not do pre-operative uroflowmetry. Quality of micturition was evaluated using a uroflowmetry. Data was analyzed using EPI info 7.0. Parametric variables were reported as means and standard deviations and percentages and counts were used to report categorical variables. Results: We had a sample of 60 patients. The mean age was 42 ± 5 years with extremes ranging from 20 to 76 years. Twenty-seven (27) patients, or 45%, had no post-operative complications, and those who did had a urinary tract infection (26.70%). In our series, we had 82% excellent results (patient satisfied with his urination with bell-shaped urinary stream and urinary flow greater than or equal to 15 ml/sec);15% good results (patient with moderate dysuria with average urinary stream and urinary flow between 10 and 14.9 ml/sec) and 3% poor results (severe dysuria with urinary flow less than 10 ml/sec, urinary retention or urinary incontinence). Based on these results we can say that the success rate in our series was 97%. 96.70% of patients were satisfied against 3.3%

关键词： Urethra Stricture Anastomotic Urethroplasty

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Epidemiological and Clinical Aspects of Male Infertility in Patients Consulting at the Urology Department of the yaounde central hospital

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 348-358页

作者： Achile Aurele Mbassi Florent Ymele Fouelifack Fatoumata Touda Dehukwe Maguira Roosvelt Dongmo Tiodjou Magloire Sida Biwole Department of Surgery and Specialties Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon Department of Urology and Andrology Yaounde Central Hospital Yaounde Cameroon Gynecology and Obstetrics Unit Yaounde Central Hospital Yaounde Cameroon Associative Group for Research Education and Health La Falaise “GARES-Falaise” Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon The Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon

Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and clinical aspects of male infertility in our setting. Methods: This was a cross-sectional and descriptive study, with retrospective data collection from the files of patients received for male infertility, over 5 years and 6 months (from January 1st, 2016 to April 30th, 2021) at the Urology Department of the yaounde central hospital. Phone calls were made to patients with incomplete records for completion following a verbal consent. Data reported on data collection forms were entered into a data entry form designed on CSPro software version 7.2. The database was later exported for descriptive statistics using the IBM SPSS software version 23. Qualitative variables were summarized in frequencies and percentages while quantitative variables were summarized in means with their standard deviations for normally distributed data, or medians and interquartile ranges otherwise. Results: Out of 110 patients whose records were analyzed, the median age was 37.0 years, with an interquartile range of 8.3, with 55.5% in the age group 30 to 39 years. Of these 95 (86.4%) were married, 58 (52.7%) were from the West region, 76 (69.1%) were employed. Past history was dominated by mumps 40 (36.4%), varicocele surgery 25 (22.7%), alcoholism 87 (79.1%) and smoking 15 (13.6%). A disorder of spermatogenesis was found in all our patients: 37 (33.6%) azoospermia, 27 (24.6%) asthenospermia and 26 (23.7%) oligospermia patients. Paraclinical evidence of chlamydia and gonococcal infections were found respectively in 38 (34.5%) and 14 (12.7%) patients, varicocele and testicular dystrophy respectively in 95 (86.4%) and 38 (34.5%) patients. Infertility was primary in 67 (60.9%) patients. Conclusion: Most patients with infertility were in their thirties, had risky soc

关键词： Epidemiology Clinical Male Infertility central hospital yaounde

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Comparative Study of Early Neonatal Complications between the First and Second Twin during Twin Vaginal Deliveries at the yaounde Gynaeco-Obstetric and Pediatric hospital, and the yaounde central hospital

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 381-392页

作者： Florent Ymele Fouelifack Felicite Nguefack Patricia Bashir Kadidja Roosvelt Dongmo Tiodjou Jeanne Hortence Fouedjio Pascal Foumane Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon Obstetrics and Gynaecology Unit of yaounde central hospital Yaounde Cameroon Associative Group for Research Education and Health La Falaise “GARES-Falaise” Dschang Cameroon Obstetrics and Gynaecology Unit of the yaounde Gynaeco-Obstetrics and Pediatric hospital Yaounde Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the yaounde Gynaeco-Obstetric and Pediatric hospital, and the yaounde central hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.

关键词： Comparison Vaginal Birth Rank of Twin Early Neonatal Complications

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Surgical Management of Lumbar Spinal Canal Stenosis with Instrumentation at the yaounde central hospital: Comparison of Unilateral versus Bilateral Pedicle Screw Fixation Combined with Transforaminal Lumbar Interbody Fusion

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Open Journal of Modern Neurosurgery 2024年第3期14卷 179-189页

作者： Orlane Toto Ndome Nassourou Oumarou Haman Dimitri Fogue Jean Bruno Ndoumou Ronaldo Fonju Anu Indira Baboke Vincent De Paul Djientcheu Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Neurosurgery Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Neurosurgery Yaounde General and Central Hospitals Yaounde Cameroon Cameroon Academy of Young Scientists Yaounde Cameroon

Introduction: The choice of adopting unilateral pedicle screw fixation or using bilateral pedicle screw fixation in lumbar spinal stenosis remains controversial. In our context, very few studies have been performed comparing the clinical effectiveness of unilateral versus bilateral fixation in the surgical management of lumbar spinal canal stenosis. Objective: Evaluate the impact on quality of life and clinical efficacy of unilateral spondylodesis compared to bilateral spondylodesis in the surgical management of lumbar spinal canal stenosis at the yaounde central hospital. Methods: This was a retrospective descriptive cross-sectional study for a period of 4 years, from June 2015 to June 2019. It involved all patients operated for lumbar canal stenosis and who underwent spondylodesis or spinal fusion at the neurosurgery department of the yaounde central hospital. Results: A total of 68 participants were recruited during our study period. 32 (47%) of the study population were in the 50 - 60 age group, with a mean age of 56.98 years ranging from 41 to 75 years. Females, housewives and farmers were the most affected. In our study, 72% of patients had unilateral spondylodesis and 28% had bilateral fusion. Preoperatively, 71% of patients had insurmountable pain, refractory to medical treatment. At 3 months postoperatively, 73.7% of patients with bilateral setup had moderate pain compared to 69% of those with unilateral setup. At 6 months postoperatively, 79% of patients with bilateral fusion had mild pain compared to 82% of patients with unilateral setup. At 1 year postoperatively, all patients had mild pain. Preoperatively, 66.2% of patients were unable to walk and 19.1% of patients were bedridden according to the Oswestry score. At 3 months postoperatively, 10.2% of patients with unilateral setup were unable to walk compared to 10.5% of patients with bilateral fixation, while 67.3% of patients with unilateral fixation had moderate disability compared to 52.6% of patient

关键词： Lumbar Spinal Canal Stenosis Instrumentation Surgery Quality of Life

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Metastatic Spinal Tumors: Diagnostic Methods, Management and Prognosis at the yaounde central hospital and yaounde General hospital

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Open Journal of Modern Neurosurgery 2024年第2期14卷 158-169页

作者： Nassourou Oumarou Haman Figuim Bello Orlane Ndome Toto Roland Ndouh Nchufor Nya Durand Bakop Ronaldo Foalou Anu Vincent de Paul Djientcheu Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Neurosurgery Department Yaounde General Hospital Yaounde Cameroon Cameroon Academy of Young Scientists Yaounde Cameroon Department of Neurosurgery Garoua General Hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Neurosurgery Douala General Hospital Douala Cameroon Facuty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Metastatic spinal tumors (MST) refer to secondary involvement of the vertebral column by hematogenously-disseminated metastatic cells. They could affect either the bony structures or the spinal cords. Mechanical instability and neurologic deficits resulting from spinal cord compression are the most common manifestations. Surgical intervention remains the most effective treatment for about 20% of patients who present with spinal cord compression. The prognosis is relatively poor. This work has as objectives to describe: the diagnostic tools, the different modalities of management and the prognostic elements of spine metastasis. Methodology: We conducted an ambispective cross-sectional descriptive study;with retrospective data collection from January 2015 to December 2021 and prospective collection from January to April 2022 in the “Neurosurgery” unit of the yaounde central hospital and the “Oncology and Neurosurgery” units of yaounde General hospital. Result: We included 101 patients. The M/F sex ratio was 1.66. The average age of the participants was 56.44 years (±14.19 SD) with a median of 58 years. Metastatic spinal tumors were discovered in 61.39% of patients with a previously known primary tumor and 21.78% of patients had newly discovered tumors. The neurologic examination revealed a vertebral syndrome in 79.21% of cases, radicular syndrome in 60.40% and sub-lesional syndrome in 59.89%. Sensory disorders accounted for 39.60% and sphincter disorders accounted for 34.65%. According to the degree of severity, the lesions were classified as Frankel E (37.62%) followed by Frankel D (21.78%). Metastatic lesions were mostly found at the thoracic vertebrae (68.25%) and lumbar vertebrae (22.22%). The most represented primary tumors were: prostate tumors (41.58%) and breast tumors (23.76%);followed by malignant hemopathies (15.84%). Computed-tomography scan (CT-scan) was the most frequent diagnostic imaging technique used (71.28%). Analgesic treatment mostly

关键词： Metastases Spinal Tumors Diagnosis Prognosis Spinal Cord Compression

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Twisting of the Spermatic Cord in an Elderly Subject at the yaounde central hospital: About a Case

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Open Journal of Urology 2022年第7期12卷 394-400页

作者： Jean Cedrick Fouda Junior Bartthelemy Mekeme Mekeme Philip Fernandez Owon’Abessolo Marcella Derboise Christelle Biyouma Ranibel Allo Axel Stephane Nwaha Makon Frantz Guy Ngalle Epoupa Landry Oriole Mbouche Cedric Mayopa Dongmo Achille Aurèle Mbassi Medjo Hell Pierre Joseph Fouda Arthur Essomba yaounde central hospital Yaounde Cameroon University of yaounde I Yaounde Cameroon University of Douala Douala Cameroon Private hospital Cameroon

Introduction: Twisting of the spermatic cord is part of urological emergencies. It can occur at any age with a predilection for children and adolescents. There is no literature on spermatic cord torsion in octogenarians, probably due to its rarity. The majority of recent studies show spermatic cord torsion in patients under 55 years of age. This is why we present a case of spermatic cord torsion in an 80 years old subject. Case Presentation: We present a case of torsion of the spermatic cord in an 80-year-old subject. The diagnosis was made on anamnestic and clinical grounds. The patient presented with scrotal pain, unilateral, of sudden onset, violent intensity without urinary signs with an ascended testicle. The urine dipstick was unremarkable. Management was done surgically and as an emergency. The postoperative course was satisfactory. Conclusion: Spermatic cord torsion in octogenarians is exceptional and should be suspected in the first instance in the presence of any sudden onset, severe testicular pain without urinary signs with an ascended testicle and a negative urine dipstick.

关键词： Twisting of the Spermatic Cord 80-Year-Old Subject Diagnostic Emergency

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Ligation of the Intersphincteric Fistula Traject with Placement of a Prosthesis: A New Technique in the Treatment of Fistula-in-Ano at yaounde central hospital (Cameroon)

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Surgical Science 2022年第2期13卷 66-77页

作者： Eric Patrick Savom Georges Roger Bwelle Motto Guy Aristide Bang Joseph Cyrille Chopkeng Ricardo Fomene Ngouanet Ghislain Loïc Batimba Nolabia Arthur Essomba yaounde General hospital Yaounde Cameroon Faculty of Medicine and Biomedical Sciences of the University of yaounde I Yaounde Cameroon yaounde central hospital Yaounde Cameroon yaounde hospital and Teaching Centre Yaounde Cameroon Higher Institute of Medical Technologies of yaounde Yaounde Cameroon

Background: Ligation of the inter-sphincter fistula tract associated with anal plug (LIFT-Plug) is a new anal fistula treatment procedure at the Yaoundé central hospital. A two-sided prosthesis piece bent in the shape of a cone is used here as an anal plug. The aim of this work was to evaluate the therapeutic results and the safety of this device. Patients and Methods: The clinical data of patients operated by the LIFT-Plug technique from January 1, 2020 to June 30, 2021 for a high anal fistula were analyzed prospectively. The variables evaluated were operative time, cure rate, postoperative complications and recurrence rate. Results: We included 28 patients with a mean age of 42 years. The sex ratio was 1.15. No patient presented preoperative continence disorder. The fistula was high trans-sphincteric in 89.3% of cases. The average duration of surgery was 55.2 minutes (45 to 66 minutes). The postoperative course was straightforward, although 60.7% of the patients had experienced tingling that resolved spontaneously. Three patients (10.7%) presented with transient gas incontinence (WIS of 4) which completely resolved after one month. All patients healed within a mean of 63.21 days (25 to 95 days). At the end of the 6-month follow-up, no case of recurrence had been recorded. Conclusion: The LIFT-Plug is a simple, safe and effective technique for the treatment of upper anal fistula without major impairment of continence despite delayed healing. The adapted two-sided prosthesis is a good alternative to the conventional anal plug.

关键词： High Anal Fistula LIFT-Plug Healing Postoperative Complications Recurrence

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Etiologic Aspects of Epileptic Seizures of Recent Onset in HIV-AIDS Infected Subjects at the yaounde central hospital (Cameroon)

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World Journal of AIDS 2013年第2期3卷 160-167页

作者： P. C. Mbonda C. Kuate A. K. Njamnshi Y. Fogang J. Fonsah W. Muna Neurology Department Central Hospital of Yaoundé University of Yaounde I Yaounde I Cameroon Neurology Department Fann Teaching Hospital Dakar Senegal

Introduction: Patients infected with HIV usually develop neurological complications. Seizures are amongst clinical manifestation of these neurological complications of HIV infection. We report on 150 HIV positive patients who presented with newly onset seizures. Objectives: Our objective was to evaluate the influence of HIV infection on epilepsy and particularly to look for the most common epilepsy induced complications in our context. Methodology: We recruited all patients infected with HIV and who consulted at the outpatient or admitted in the in the neurology unit of the yaounde central hospital, for seizures from August 1st 2008 to December 31st 2009. All the patients were aged above 18 years, black and of Cameroonian nationality. All those who had a family history of epilepsy, as well as those with a personal history of epilepsy were excluded from the study. Results: During the period of study, we recruited 150 patients aged 38.7 ± 9.9 years and with an M/F sex ratio of 0.76. Generalized seizures were observed in 66% of patients, of whom 58% were HIV 1 positive and an average CD4 count of 65.4 ± 11.7/μl. Cerebral toxoplasmosis was the most common etiology observed in 30% of cases. Discussion: This study being hospital based must have selected the most serious patient with severe immunodeficiency. This can explain why a precise etiology was found in the majority of cases. Modi et al. (1999) found a space occupying lesion in 53%, meningitis in 22% and 25% without identifiable etiology in black South Africans. central nervous system tuberculosis was the most frequent cause encountered in 64% of patients with etiologies. Conclusion: Seizures are one of the principal manifestations of HIV infection or its complications. Their prevalence is 9.5% in our study. Cerebral toxoplasmosis is the most frequent etiology in our study, followed by cryptococcal meningitis and tuberculous meningitis.

关键词： Epilepsy HIV/AIDS Infection Cerebral Toxoplasmosis—Yaoundé (Cameroon)

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Abdominal Pregnancy: Epidemiological, Diagnostic, Therapeutic and Prognostic Aspects: A Case Report from the yaounde central hospital (Cameroon)

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Open Journal of Obstetrics and Gynecology 2021年第4期11卷 381-390页

作者： Armand Kamga Talom Florent Fouelifack Ymele Madye Ngo Dingom Jeanne Fouedjio Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences University of Yaounde I Cameroon yaounde central hospital Cameroon Higher Institute of Medical Technology Yaounde Cameroon

Abdominal pregnancy (AP) is a relatively rare and potentially serious form of ectopic pregnancies (EPs). We report the case of a haemorrhagic abdominal pregnancy at 15 weeks of amenorrhea complicated by hypovolaemic shock, with a favorable outcome. Our aim is to outline the epidemiological, clinical, therapeutic and prognostic features of this condition.

关键词： Abdominal Pregnancy Epidemiology Prognosis Yaoundé Cameroon

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Experience on the Management of Priapism at the yaounde central hospital

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Open Journal of Urology 2024年第4期14卷 244-251页

作者： Philip Fernandez Owon’Abessolo Jean Cédric Fouda Armel Essomba Cécile Etobe Achille Kpanou Yellem Yvon Gerard Beling Abanda Bright Awondo-Che Milama Steves Ndang Ngou Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Urology Service Yaound&#233 Central Hospital Yaound&#233 Cameroon Department of Surgery and Specialty Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon Department of Urology University of Health Sciences Owendo Gabon

Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. However, the management is often late because of the delay in consultation, which is characteristic in our context. The purpose of our study is to describe the clinical and therapeutic aspects of patients who presented with priapism at the Yaoundé central hospital as well as to propose a present synthesis concerning the management of priapism. Methodology: We conducted a descriptive cross-sectional study with a retrospective recruitment method in the urology department of the YCH. It extended over a period of 6 months from January 2022 to June 2022. We reviewed the files of patients seen within a period spanning 10 years from January 1st, 2011 to January 31st, December 2021. The study population consisted of patients who had been hospitalized and treated for priapism. We carried out consecutive and non-exhaustive sampling. Results: During the study, we collected data from the medical files of 13 patients. The median age was 25 years, with extremes of 12 and 82 years. Most of the patients were between 20 and 30 years old (38.5%). Most of the patients were single (69.2%). Sickle cell disease was the main comorbidity encountered during the study (76.9%). The median time from onset of symptoms to consultation was 10 [6 - 20.5] hours, with extremes of 1 and 264 hours. All patients presented with painful penile erection (100%). There was concomitant multifocal pain in 38.5% of cases suggestive of vaso-occlusive crises (VOC). The symptoms occurred in a non-traumatic context in the majority of cases (92.3%). The T-shunt was the most used surgical technique (84.6%). The median duration of surgery was 36 [35 - 40] minutes with extremes of 25 and 60 minutes, the majority being operated in less than 45 minutes (84.6%). The frequency of postopera

关键词： Priapism Treatment Experience

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