Background Genome-wide association studies do not always replicate well across populations, limit... more Background Genome-wide association studies do not always replicate well across populations, limiting the generalizability of polygenic risk scores (PRS). Despite higher incidence and mortality rates of prostate cancer in men of African descent, much of what is known about cancer genetics comes from populations of European descent. To understand how well genetic predictions perform in different populations, we evaluated test characteristics of PRS from three previous studies using data from the UK Biobank and a novel dataset of 1298 prostate cancer cases and 1333 controls from Ghana, Nigeria, Senegal, and South Africa. Results Allele frequency differences cause predicted risks of prostate cancer to vary across populations. However, natural selection is not the primary driver of these differences. Comparing continental datasets, we find that polygenic predictions of case vs. control status are more effective for European individuals (AUC 0.608–0.707, OR 2.37–5.71) than for African ind...
Objectif: Il n'existe pas de consensus concernant la capacité de la varicocélectomie à amélio... more Objectif: Il n'existe pas de consensus concernant la capacité de la varicocélectomie à améliorer la fertilité et la fécondité. L'objectif de cette étude rétrospective était d'étudier l'évolution postopératoire de la fertilité masculine (par les paramètres du spermogramme) et celle de la fécondité du couple. Patients et méthodes: Il s'agit d'une étude rétrospective de 50 patients porteurs de varicocèle palpable opérés selon la technique de Palomo au service d'Urologie de l'Hôpital Grand Yoff, Dakar, Sénégal. Les paramètres étudiés sont les paramètres du spermogramme (densité, mobilité totale à la première heure, vitalité) et du spermocytogramme (taux de spermatozoïdes de morphologie normale), une fois avant l'opération et à deux reprises après (entre le 3ème et le 8ème mois et à partir du 9ème mois) et la fécondité postopératoire du couple chez 35 patients. Résultats : L'étude du spermogramme retrouve, pour l'ensemble des patients, une élév...
We present three cases of urethral prolapse in prepubertal females in Senegal who presented with ... more We present three cases of urethral prolapse in prepubertal females in Senegal who presented with vulvar bleeding. Careful gynecologic and urologic physical exams were performed and revealed urethral origin and prolapse. Conservative versus surgical approaches were taken in different patients, but ultimately, each patient received a urethral meatoplasty. Surgical excision of these masses yielded a full recovery in the patients. A careful review of the literature was then undertaken and showed that surgical excision or ligation of the prolapse is preferable to more conservative treatment. The case series article discusses the rare occurrence of urethral prolapse, as well as the epidemiology and prognostic and therapeutic implications of urethral prolapse in prepubertal females. Introduction. Urethral prolapse is a rare condition occurring mostly in young black females. It can be worrying to the parents as it often causes vulvar bleeding. Case Presentation. We present three cases of ur...
Limited cases of bladder teratomas in the pediatric population have been published. Often, these ... more Limited cases of bladder teratomas in the pediatric population have been published. Often, these tumors will present as hematuriawhich is regarded as benign. Because of this presentation, pediatric patients often are not diagnosed until years after their initial presentation. We present a 4-year-old female patient who presented initially at 6 months with progressive hematuria that ultimately ended up being diagnosed with a bladder teratoma. In conclusion, bladder teratomas should be included in the initial work-up when presenting with hematuria. Médina Ndoye1, Lissoune Cissé2, Michael Caro3, Shana Santarelli3*, Clayton Bunting3, Mohamed Jalloh1, Mouhamadou M Mbodji1 and Serigne Gueye1 1Idrissa Pauce Grand Yoff General Hospital, Senegal 2Albert Royer Children Hospital, Senegal 3Department of Medicine, Philadelphia College of Medicine, USA Shana Santarelli, et al., Clinical Case Reports International General Medicine Remedy Publications LLC., | http://clinicalcasereportsint.com/ 2021 ...
Author(s): Patino, German; Ndoye, Medina; Thomas, Hannah S; Cohen, Andrew J; Mmonu, Nnenaya A; Ch... more Author(s): Patino, German; Ndoye, Medina; Thomas, Hannah S; Cohen, Andrew J; Mmonu, Nnenaya A; Chu, Carissa E; Breyer, Benjamin N | Abstract: Objective Clinical practice guidelines (CPGs) serve as frameworks to unify diagnostic criteria and guide clinical decision-making. There is a paucity of literature surrounding the uptake of CPGs in urology practice settings with varied levels of resources worldwide. This study aims to evaluate reported use of CPGs within the context of international urology practice, identify local barriers to uptake, and evaluate the role of stakeholders in the CPG-development process. Methods This was an international, multi-center, cross-sectional study. An online survey collecting variables pertaining to the use of CPGs was distributed to attending/consultant urologists in Latin America, Africa, and China. Statistical analysis was conducted using R software. Result A total of 249 practicing urologists from 28 countries completed the survey. The majority of...
La nephrectomie totale est proposee pour diverses pathologies renales, notamment tumorales, infec... more La nephrectomie totale est proposee pour diverses pathologies renales, notamment tumorales, infectieuses ou lithiasiques. Ailleurs une chirurgie moins radicale est effectuee de facon conventionnelle, par coeliochirurgie, par endoscopie ou autres methodes therapeutiques. Dans notre contexte, des pathologies renales sont encore decouvertes a des stades tardifs qui justifient cette nephrectomie totale. La chirurgie renale, du fait de la situation anatomique profonde et des rapports etroits du rein, est lourde et non denouee de risques et de retentissements peri-operatoires importants. Ainsi notre objectif etait d’etudier la morbidite et la mortalite liees a la nephrectomie totale dans notre pratique. Il s’agissait d’une etude retrospective multicentrique menee dans les services d’urologie de l’Hopital General de Grand Yoff et de l’Hopital principal de Dakar sur une periode de 10 ans (2002 a 2011). Le critere d’inclusion etait tout patient ayant eu une nephrectomie totale quelle que soi...
Bilateral duplicated system with ectopic ureter is a rare entity. Duplication and its associated ... more Bilateral duplicated system with ectopic ureter is a rare entity. Duplication and its associated anomalies are more common in females. Anomalies of the renal collecting system should be considered by clinicians and surgeons in patients presenting with urinary incontinence. We present a 32-year-old female with a Bilateral Ureteral Duplication with Right Ectopic Ureter presenting with low volume Incontinence. We emphasized the importance of imaging in the diagnosis of anomalies of the renal collecting system presenting with incontinence. In the absence of a dysplastic renal moiety, an ureteroneocystostomy is an ideal procedure of choice to correct incontinence from ectopic ureters in females.
There is a global variation in the incidence of renal masses with the developed nations having a ... more There is a global variation in the incidence of renal masses with the developed nations having a greater incidence. About 80–90% of renal malignancies are renal cell carcinomas (RCC) which account for 2–4% of all cancers. In Africa and the Middle East, the age-standardized incidence for RCC is 1.8–4.8/100,000 for males and 1.2–2.2/100,000 for females. The management of renal cell cancer is challenging. A multidisciplinary approach is effective for diagnosis, staging, and treatment. Guidelines recommend active surveillance, thermal ablation, partial nephrectomy, radical nephrectomy, cytoreductive nephrectomy and immunotherapy as various modalities for various stages of RCC. However, open radical nephrectomy is most widely adopted as an option for treatment at various stages of the disease in sub-Saharan Africa due to its cost-effectiveness, applicability at various stages, and the reduced cost of follow-up. Nevertheless, most patients in the region present with the disease in the adv...
Objectives: To report the experiment conducted at the HOGGY Urology department in the management ... more Objectives: To report the experiment conducted at the HOGGY Urology department in the management of urethral stricture by urethroplasty, and to determine the factors that influence the results. Material and Method: We conducted a descriptive and analytical retrospective study based on the records of patients who underwent urethroplasty in the department, between February 2001 and September 2013. Results: Ninety-one (91) patients were enrolled. Urethroplasties prevalence was 0.83% of the surgical activity of the service. The mean age of patients was 39.83 years. Dysuria (30.77%) followed by pelvic trauma (28.57%) and urinary retentions (25.27%) was the main discovery mode. A periurethral coating was found in 32 patients. The infectious etiology accounted for 44% of cases. In 63% of cases, diagnostic was made by retrograde cystography. The penile urethra was the favorite seat of the UR in 70% of cases. The average length of the urethral stricture (US) was less than 1 cm in 41.17% of cases. The US was unique in more than half of the cases (58.33%). Anastomotic urethroplasty was the best surgical technique with 73.63% of patients. Postoperative morbidity involved 47 patients and was dominated by urinary infections (36 year old). The average duration of follow-up of operated patients was 29 months. After 6 months of follow-up, the best results were obtained with the termino-terminal urethroplasty technique with 62.5%. After a follow-up of 4 years, the success rate was 58.24%. The length of the stenosis and the allocation of gestures on the urethra were the two factors of failure. Conclusion: Stenosis is common in our regions. Treatment results are disappointing. Urethroplasty is the gold standard of surgical treatment and anastomotic urethroplasty gives better results.
The estimated incidence rate of prostate cancer in Africa was 22.0/100,000 in 2016. The Internati... more The estimated incidence rate of prostate cancer in Africa was 22.0/100,000 in 2016. The International Agency for Research on Cancer (IARC) has cited prostate cancer as a growing health threat in Africa with approximated 28,006 deaths in 2010 and estimated 57,048 deaths in 2030. The exact incidence of advanced and metastatic prostate cancer is not known in sub-Saharan Africa. Hospital-based reports from the region have shown a rising trend with most patients presenting with advanced or metastatic disease. The management of advanced and metastatic prostate cancer is challenging. The available international guidelines may not be cost-effective for an African population. The most efficient approach in the region has been surgical castration by bilateral orchidectomy or pulpectomy. Medical androgen deprivation therapy is expensive and may not be available. Patients with metastatic castrate-resistant prostate cancer tend to be palliated due to the absence or cost of chemotherapy or second...
MM et al. 180°congenital penile torsion with distal hypospadias mistaken for an epispadias: Optim... more MM et al. 180°congenital penile torsion with distal hypospadias mistaken for an epispadias: Optimal outcome with tubularized incised plate urethroplasty and dartos flap rotation.
Le but de l'étude était de rapporter les indications et les résultats de la dérivation du haut ap... more Le but de l'étude était de rapporter les indications et les résultats de la dérivation du haut appareil urinaire par sonde double J au service d'urologie de l'hôpital général de Grand Yoff (HOGGY). Patients et méthodes : Il s'agissait d'une étude rétrospective monocentrique de type descriptif allant du 01 janvier 2014 au 31 décembre 2015 portant sur les dossiers des patients ayant eu une montée de sonde JJ comme type de dérivation du haut appareil urinaire. Résultats : Quarante-quatre dossiers de patients avaient été inclus. L'âge moyen des patients était de 47,9 ans avec des extrêmes de 20 et 75 ans. Les femmes représentaient 68 % des cas. Le sex-ratio était de 0,47. L'urétérohydronéphrose était la principale indication de la montée de sonde JJ avec 95,5 % des patients. Elle était bilatérale dans 42,86 % des cas, et compliquée d'insuffisance rénale chez 47,73 % des patients. La colique néphrétique obstructive représentait 22,73 % des indications. Les étiologies étaient dominées par la lithiase urinaire avec 29,55 % des cas, suivie des étiologies tumorales avec 27,27 % des cas dont la tumeur du col de l'utérus dans 18,18 % des cas. La montée de sonde JJ a été réalisée sans contrôle fluoroscopique (à l'aveugle) dans 54,55 % des cas avec 66,67 % de succès. Le taux de succès global était de 65,1 %. La fonction rénale des malades avec insuffisance rénale en préopératoire s'était améliorée chez 57,15 % de cas. Un seul malade (2,33 % des cas) avait présenté une complication postopératoire. Conclusion : La montée de sonde JJ est une technique efficace et mini-invasive de dérivation du haut appareil urinaire en vue d'une préservation de la fonction rénale. Sa réalisation sans guidage fluoroscopique est possible mais au prix d'une rigoureuse sélection des malades.
Présenter les résultats de la pratique de l'urétéroscopie à l'Hôpital Général Grand Yoff (HOGGY) ... more Présenter les résultats de la pratique de l'urétéroscopie à l'Hôpital Général Grand Yoff (HOGGY) de Dakar (Sénégal). Sujets et méthodes : Il s'agit d'une étude descriptive de 91 urétéroscopies effectuées dans le service d'Urologie de l'Hôpital Général Grand Yoff de janvier 2012 à décembre 2013. Les variables de l'étude étaient l'indication, l'âge, la nature de l'urétéroscopie associées ou non au laser, les résultats de la lithotripsie. Résultats : Sept urétéroscopies diagnostiques et 84 urétéroscopies thérapeutiques ont été effectuées. L'âge moyen des patients était de 44,7 ans +-13,9 ans. L'urétéroscope semi rigide a été utilisé dans 43 cas, l'urétéroscope souple dans 15 cas, l'urétéroscope rigide dans 9 cas. La topographie du calcul était pyélique dans 30 cas, lombaire dans 28 cas, pelvienne dans 13 cas, calicielle dans 10 cas et iliaque dans 3 cas. Le nombre de calcul fragmenté au laser était de 87 calculs. Les complications étaient dominées par les fausses routes dans 8 cas. Le succès global de l'urétéroscopie était de 85,7%. Conclusion : La pratique courante de l'urétéroscopie constitue un défi pour l'urologue en Afrique subsaharienne. Elle est devenue le traitement de choix de la lithiase de la voie excrétrice supérieure.
Objective: The aim was to assess the place of endourologic intervention in our practice and compa... more Objective: The aim was to assess the place of endourologic intervention in our practice and compare it to open surgery in the management of upper urinary tract calculi in Senegal. Patients and Methods: This was a retrospective study conducted at both the Principal and Grand Yoff Hospitals of Dakar from January 2009 to December 2013 in which 89 patients with upper urinary tract calculi were mobilized. All patients with symptomatic upper urinary tract colic symptoms were included. Results: Eighty-nine were followed up during the study period, 63 men and 36 women (sex of ratio 1.2). The average age was 44 years with extremes 22-75 years. Forty two patients, including 28 men and 14 women (sex ratio 1: 2) were treated with open surgery. The mean age was 42.75 years (4-75 years). The average duration of hospitalization after open surgery was 8 days (4-60 days). The mean stone size in open surgery was 23 mm (5 mm-45 mm). Complications noted were: 2 cases of urinomas (4.76%), 1 case of lower back fistula (2.38%), 1 case of renal pelvis fistula (2.38%) and 1 case (2.38%) of infection. Forty seven patients including 35 men (55.6%) and 12 women (46.2%) were treated by endourology. The average length of hospital stay was 2 days (2 d-3 d). The average stone size treated by endourology was 13 mm (5 mm-40 mm). No complications were observed in this group. The cost of open surgery was a third of that of endourology. Conclusion: Endoscopic surgery, as is observed from industrialized countries occupies a prominent place in the treatment of upper urinary tract calculi in Senegal; however, the only limiting factor encountered is the cost which remains out of reach for patients and burdening the
MOTS CLÉS Cystoscopie; endoscopie; symptômes du bas appareil urinaire; ambulatoire Résumé But de ... more MOTS CLÉS Cystoscopie; endoscopie; symptômes du bas appareil urinaire; ambulatoire Résumé But de l'étude : Déterminer le profil des patients ayant subi une urétrocystoscopie et d'en décrire les indications, résultats et les gestes complémentaires réalisés. Patients et méthodes : Il s'agit d'une étude descriptive rétrospective des patients ayant subi une urétrocystoscopie en ambulatoire au service d'Urologie et Andrologie de l'Hôpital Général Grand Yoff de Dakar. Les caractéristiques démographiques des patients, les indications, les résultats et les gestes complémentaires de l'examen ont été saisis et analysées dans Epi Info 7 version 3.5.3. Nous avons fait des statistiques descriptives. Résultats : Sur 655 patients ayant subi une urétrocystoscopie, il y'avait 403 hommes et 252 femmes (sex ratio:1,6). L'âge moyen des patients était de 47,44 ans et 27,94% des patients étaient dans la tranche d'âge [40-60 ans]. Les principales indications de l'examen étaient l'hématurie (31,49%), les troubles urinaires du bas appareil (26,44%). Les résultats étaient dominés par les tumeurs de vessie (18,2%), l'hypertrophie prostatique (12,4%), les cystopathies (8,2%) et les lésions bilharziennes (8,1%). Une tumeur de vessie a été trouvée dans 26,45% des cas d'hématurie. Conclusion : L'urétroystoscopie est un examen important surtout en pathologie tumorale. L'hématurie en était la principale indication mettant en évidence surtout les tumeurs de vessie et l'hypertrophie prostatique mais aussi les pathologies inflammatoires de la vessie.
Primary tumors of the upper urinary tract are rarely reported in the literature. We thus report h... more Primary tumors of the upper urinary tract are rarely reported in the literature. We thus report here four cases of primary tumors of the upper urinary tract that were difficult to diagnose, in three women and one man. Preoperative diagnosis was established in only two cases requiring a nephro-ureterectomy. The other two cases were surprisingly diagnosed during anatomopathological examination. Preoperative diagnosis was a pyonephrosis in one case and a renal failure resulting from stenosis of the pelvic ureter in the other. Despite modern methods, primary tumors of the upper urinary tract remain difficult to diagnose.
Prostate cancer is the leading male cancer worldwide. While there are abundant data on the epidem... more Prostate cancer is the leading male cancer worldwide. While there are abundant data on the epidemiology, natural history, treatment and outcomes of the disease in the US and many developed countries, prostate cancer is a good example of cancer disparity in that a little is known about the disease in Sub Saharan Africa. Because of the dominant black race in this region and the fact that black men suffer the higher burden of the disease, it is important to understand that cancer in this population. The purpose of this review is to describe the literature of prostate cancer in Sub Saharan Africa. The authors reviewed the published studies on prostate cancer in Sub Saharan Africa available on PubMed. In addition any other accessible study on the topic was included.
Bothrops asper inflicts the majority of snakebites in Central America and in the northern regions... more Bothrops asper inflicts the majority of snakebites in Central America and in the northern regions of South America, mostly affecting young agricultural workers in rural settings. This species is capable of provoking severe envenomings associated with local and systemic manifestations. The main clinical features are: local edema, ecchymoses, blisters, dermonecrosis, myonecrosis, defibrinogenation, thrombocytopenia, systemic bleeding, hypotension and renal alterations. In addition, soft-tissue infection, acute renal failure, compartmental syndrome, central nervous system hemorrhage and, in pregnant women, abortion, fetal wastage and abruptio placentae have been described as complications. Intravenous administration of antivenom constitutes the mainstay in the therapy. Antivenoms composed of either whole IgG or F(ab 0) 2 fragments, manufactured in Brazil, Colombia, Costa Rica and Mexico, have been tested in controlled clinical trials, and rational protocols for antivenom administration have been developed. In addition to antivenom therapy, a number of ancillary interventions are recommended in the treatment of B. asper bites.
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Background Genome-wide association studies do not always replicate well across populations, limit... more Background Genome-wide association studies do not always replicate well across populations, limiting the generalizability of polygenic risk scores (PRS). Despite higher incidence and mortality rates of prostate cancer in men of African descent, much of what is known about cancer genetics comes from populations of European descent. To understand how well genetic predictions perform in different populations, we evaluated test characteristics of PRS from three previous studies using data from the UK Biobank and a novel dataset of 1298 prostate cancer cases and 1333 controls from Ghana, Nigeria, Senegal, and South Africa. Results Allele frequency differences cause predicted risks of prostate cancer to vary across populations. However, natural selection is not the primary driver of these differences. Comparing continental datasets, we find that polygenic predictions of case vs. control status are more effective for European individuals (AUC 0.608–0.707, OR 2.37–5.71) than for African ind...
Objectif: Il n'existe pas de consensus concernant la capacité de la varicocélectomie à amélio... more Objectif: Il n'existe pas de consensus concernant la capacité de la varicocélectomie à améliorer la fertilité et la fécondité. L'objectif de cette étude rétrospective était d'étudier l'évolution postopératoire de la fertilité masculine (par les paramètres du spermogramme) et celle de la fécondité du couple. Patients et méthodes: Il s'agit d'une étude rétrospective de 50 patients porteurs de varicocèle palpable opérés selon la technique de Palomo au service d'Urologie de l'Hôpital Grand Yoff, Dakar, Sénégal. Les paramètres étudiés sont les paramètres du spermogramme (densité, mobilité totale à la première heure, vitalité) et du spermocytogramme (taux de spermatozoïdes de morphologie normale), une fois avant l'opération et à deux reprises après (entre le 3ème et le 8ème mois et à partir du 9ème mois) et la fécondité postopératoire du couple chez 35 patients. Résultats : L'étude du spermogramme retrouve, pour l'ensemble des patients, une élév...
We present three cases of urethral prolapse in prepubertal females in Senegal who presented with ... more We present three cases of urethral prolapse in prepubertal females in Senegal who presented with vulvar bleeding. Careful gynecologic and urologic physical exams were performed and revealed urethral origin and prolapse. Conservative versus surgical approaches were taken in different patients, but ultimately, each patient received a urethral meatoplasty. Surgical excision of these masses yielded a full recovery in the patients. A careful review of the literature was then undertaken and showed that surgical excision or ligation of the prolapse is preferable to more conservative treatment. The case series article discusses the rare occurrence of urethral prolapse, as well as the epidemiology and prognostic and therapeutic implications of urethral prolapse in prepubertal females. Introduction. Urethral prolapse is a rare condition occurring mostly in young black females. It can be worrying to the parents as it often causes vulvar bleeding. Case Presentation. We present three cases of ur...
Limited cases of bladder teratomas in the pediatric population have been published. Often, these ... more Limited cases of bladder teratomas in the pediatric population have been published. Often, these tumors will present as hematuriawhich is regarded as benign. Because of this presentation, pediatric patients often are not diagnosed until years after their initial presentation. We present a 4-year-old female patient who presented initially at 6 months with progressive hematuria that ultimately ended up being diagnosed with a bladder teratoma. In conclusion, bladder teratomas should be included in the initial work-up when presenting with hematuria. Médina Ndoye1, Lissoune Cissé2, Michael Caro3, Shana Santarelli3*, Clayton Bunting3, Mohamed Jalloh1, Mouhamadou M Mbodji1 and Serigne Gueye1 1Idrissa Pauce Grand Yoff General Hospital, Senegal 2Albert Royer Children Hospital, Senegal 3Department of Medicine, Philadelphia College of Medicine, USA Shana Santarelli, et al., Clinical Case Reports International General Medicine Remedy Publications LLC., | http://clinicalcasereportsint.com/ 2021 ...
Author(s): Patino, German; Ndoye, Medina; Thomas, Hannah S; Cohen, Andrew J; Mmonu, Nnenaya A; Ch... more Author(s): Patino, German; Ndoye, Medina; Thomas, Hannah S; Cohen, Andrew J; Mmonu, Nnenaya A; Chu, Carissa E; Breyer, Benjamin N | Abstract: Objective Clinical practice guidelines (CPGs) serve as frameworks to unify diagnostic criteria and guide clinical decision-making. There is a paucity of literature surrounding the uptake of CPGs in urology practice settings with varied levels of resources worldwide. This study aims to evaluate reported use of CPGs within the context of international urology practice, identify local barriers to uptake, and evaluate the role of stakeholders in the CPG-development process. Methods This was an international, multi-center, cross-sectional study. An online survey collecting variables pertaining to the use of CPGs was distributed to attending/consultant urologists in Latin America, Africa, and China. Statistical analysis was conducted using R software. Result A total of 249 practicing urologists from 28 countries completed the survey. The majority of...
La nephrectomie totale est proposee pour diverses pathologies renales, notamment tumorales, infec... more La nephrectomie totale est proposee pour diverses pathologies renales, notamment tumorales, infectieuses ou lithiasiques. Ailleurs une chirurgie moins radicale est effectuee de facon conventionnelle, par coeliochirurgie, par endoscopie ou autres methodes therapeutiques. Dans notre contexte, des pathologies renales sont encore decouvertes a des stades tardifs qui justifient cette nephrectomie totale. La chirurgie renale, du fait de la situation anatomique profonde et des rapports etroits du rein, est lourde et non denouee de risques et de retentissements peri-operatoires importants. Ainsi notre objectif etait d’etudier la morbidite et la mortalite liees a la nephrectomie totale dans notre pratique. Il s’agissait d’une etude retrospective multicentrique menee dans les services d’urologie de l’Hopital General de Grand Yoff et de l’Hopital principal de Dakar sur une periode de 10 ans (2002 a 2011). Le critere d’inclusion etait tout patient ayant eu une nephrectomie totale quelle que soi...
Bilateral duplicated system with ectopic ureter is a rare entity. Duplication and its associated ... more Bilateral duplicated system with ectopic ureter is a rare entity. Duplication and its associated anomalies are more common in females. Anomalies of the renal collecting system should be considered by clinicians and surgeons in patients presenting with urinary incontinence. We present a 32-year-old female with a Bilateral Ureteral Duplication with Right Ectopic Ureter presenting with low volume Incontinence. We emphasized the importance of imaging in the diagnosis of anomalies of the renal collecting system presenting with incontinence. In the absence of a dysplastic renal moiety, an ureteroneocystostomy is an ideal procedure of choice to correct incontinence from ectopic ureters in females.
There is a global variation in the incidence of renal masses with the developed nations having a ... more There is a global variation in the incidence of renal masses with the developed nations having a greater incidence. About 80–90% of renal malignancies are renal cell carcinomas (RCC) which account for 2–4% of all cancers. In Africa and the Middle East, the age-standardized incidence for RCC is 1.8–4.8/100,000 for males and 1.2–2.2/100,000 for females. The management of renal cell cancer is challenging. A multidisciplinary approach is effective for diagnosis, staging, and treatment. Guidelines recommend active surveillance, thermal ablation, partial nephrectomy, radical nephrectomy, cytoreductive nephrectomy and immunotherapy as various modalities for various stages of RCC. However, open radical nephrectomy is most widely adopted as an option for treatment at various stages of the disease in sub-Saharan Africa due to its cost-effectiveness, applicability at various stages, and the reduced cost of follow-up. Nevertheless, most patients in the region present with the disease in the adv...
Objectives: To report the experiment conducted at the HOGGY Urology department in the management ... more Objectives: To report the experiment conducted at the HOGGY Urology department in the management of urethral stricture by urethroplasty, and to determine the factors that influence the results. Material and Method: We conducted a descriptive and analytical retrospective study based on the records of patients who underwent urethroplasty in the department, between February 2001 and September 2013. Results: Ninety-one (91) patients were enrolled. Urethroplasties prevalence was 0.83% of the surgical activity of the service. The mean age of patients was 39.83 years. Dysuria (30.77%) followed by pelvic trauma (28.57%) and urinary retentions (25.27%) was the main discovery mode. A periurethral coating was found in 32 patients. The infectious etiology accounted for 44% of cases. In 63% of cases, diagnostic was made by retrograde cystography. The penile urethra was the favorite seat of the UR in 70% of cases. The average length of the urethral stricture (US) was less than 1 cm in 41.17% of cases. The US was unique in more than half of the cases (58.33%). Anastomotic urethroplasty was the best surgical technique with 73.63% of patients. Postoperative morbidity involved 47 patients and was dominated by urinary infections (36 year old). The average duration of follow-up of operated patients was 29 months. After 6 months of follow-up, the best results were obtained with the termino-terminal urethroplasty technique with 62.5%. After a follow-up of 4 years, the success rate was 58.24%. The length of the stenosis and the allocation of gestures on the urethra were the two factors of failure. Conclusion: Stenosis is common in our regions. Treatment results are disappointing. Urethroplasty is the gold standard of surgical treatment and anastomotic urethroplasty gives better results.
The estimated incidence rate of prostate cancer in Africa was 22.0/100,000 in 2016. The Internati... more The estimated incidence rate of prostate cancer in Africa was 22.0/100,000 in 2016. The International Agency for Research on Cancer (IARC) has cited prostate cancer as a growing health threat in Africa with approximated 28,006 deaths in 2010 and estimated 57,048 deaths in 2030. The exact incidence of advanced and metastatic prostate cancer is not known in sub-Saharan Africa. Hospital-based reports from the region have shown a rising trend with most patients presenting with advanced or metastatic disease. The management of advanced and metastatic prostate cancer is challenging. The available international guidelines may not be cost-effective for an African population. The most efficient approach in the region has been surgical castration by bilateral orchidectomy or pulpectomy. Medical androgen deprivation therapy is expensive and may not be available. Patients with metastatic castrate-resistant prostate cancer tend to be palliated due to the absence or cost of chemotherapy or second...
MM et al. 180°congenital penile torsion with distal hypospadias mistaken for an epispadias: Optim... more MM et al. 180°congenital penile torsion with distal hypospadias mistaken for an epispadias: Optimal outcome with tubularized incised plate urethroplasty and dartos flap rotation.
Le but de l'étude était de rapporter les indications et les résultats de la dérivation du haut ap... more Le but de l'étude était de rapporter les indications et les résultats de la dérivation du haut appareil urinaire par sonde double J au service d'urologie de l'hôpital général de Grand Yoff (HOGGY). Patients et méthodes : Il s'agissait d'une étude rétrospective monocentrique de type descriptif allant du 01 janvier 2014 au 31 décembre 2015 portant sur les dossiers des patients ayant eu une montée de sonde JJ comme type de dérivation du haut appareil urinaire. Résultats : Quarante-quatre dossiers de patients avaient été inclus. L'âge moyen des patients était de 47,9 ans avec des extrêmes de 20 et 75 ans. Les femmes représentaient 68 % des cas. Le sex-ratio était de 0,47. L'urétérohydronéphrose était la principale indication de la montée de sonde JJ avec 95,5 % des patients. Elle était bilatérale dans 42,86 % des cas, et compliquée d'insuffisance rénale chez 47,73 % des patients. La colique néphrétique obstructive représentait 22,73 % des indications. Les étiologies étaient dominées par la lithiase urinaire avec 29,55 % des cas, suivie des étiologies tumorales avec 27,27 % des cas dont la tumeur du col de l'utérus dans 18,18 % des cas. La montée de sonde JJ a été réalisée sans contrôle fluoroscopique (à l'aveugle) dans 54,55 % des cas avec 66,67 % de succès. Le taux de succès global était de 65,1 %. La fonction rénale des malades avec insuffisance rénale en préopératoire s'était améliorée chez 57,15 % de cas. Un seul malade (2,33 % des cas) avait présenté une complication postopératoire. Conclusion : La montée de sonde JJ est une technique efficace et mini-invasive de dérivation du haut appareil urinaire en vue d'une préservation de la fonction rénale. Sa réalisation sans guidage fluoroscopique est possible mais au prix d'une rigoureuse sélection des malades.
Présenter les résultats de la pratique de l'urétéroscopie à l'Hôpital Général Grand Yoff (HOGGY) ... more Présenter les résultats de la pratique de l'urétéroscopie à l'Hôpital Général Grand Yoff (HOGGY) de Dakar (Sénégal). Sujets et méthodes : Il s'agit d'une étude descriptive de 91 urétéroscopies effectuées dans le service d'Urologie de l'Hôpital Général Grand Yoff de janvier 2012 à décembre 2013. Les variables de l'étude étaient l'indication, l'âge, la nature de l'urétéroscopie associées ou non au laser, les résultats de la lithotripsie. Résultats : Sept urétéroscopies diagnostiques et 84 urétéroscopies thérapeutiques ont été effectuées. L'âge moyen des patients était de 44,7 ans +-13,9 ans. L'urétéroscope semi rigide a été utilisé dans 43 cas, l'urétéroscope souple dans 15 cas, l'urétéroscope rigide dans 9 cas. La topographie du calcul était pyélique dans 30 cas, lombaire dans 28 cas, pelvienne dans 13 cas, calicielle dans 10 cas et iliaque dans 3 cas. Le nombre de calcul fragmenté au laser était de 87 calculs. Les complications étaient dominées par les fausses routes dans 8 cas. Le succès global de l'urétéroscopie était de 85,7%. Conclusion : La pratique courante de l'urétéroscopie constitue un défi pour l'urologue en Afrique subsaharienne. Elle est devenue le traitement de choix de la lithiase de la voie excrétrice supérieure.
Objective: The aim was to assess the place of endourologic intervention in our practice and compa... more Objective: The aim was to assess the place of endourologic intervention in our practice and compare it to open surgery in the management of upper urinary tract calculi in Senegal. Patients and Methods: This was a retrospective study conducted at both the Principal and Grand Yoff Hospitals of Dakar from January 2009 to December 2013 in which 89 patients with upper urinary tract calculi were mobilized. All patients with symptomatic upper urinary tract colic symptoms were included. Results: Eighty-nine were followed up during the study period, 63 men and 36 women (sex of ratio 1.2). The average age was 44 years with extremes 22-75 years. Forty two patients, including 28 men and 14 women (sex ratio 1: 2) were treated with open surgery. The mean age was 42.75 years (4-75 years). The average duration of hospitalization after open surgery was 8 days (4-60 days). The mean stone size in open surgery was 23 mm (5 mm-45 mm). Complications noted were: 2 cases of urinomas (4.76%), 1 case of lower back fistula (2.38%), 1 case of renal pelvis fistula (2.38%) and 1 case (2.38%) of infection. Forty seven patients including 35 men (55.6%) and 12 women (46.2%) were treated by endourology. The average length of hospital stay was 2 days (2 d-3 d). The average stone size treated by endourology was 13 mm (5 mm-40 mm). No complications were observed in this group. The cost of open surgery was a third of that of endourology. Conclusion: Endoscopic surgery, as is observed from industrialized countries occupies a prominent place in the treatment of upper urinary tract calculi in Senegal; however, the only limiting factor encountered is the cost which remains out of reach for patients and burdening the
MOTS CLÉS Cystoscopie; endoscopie; symptômes du bas appareil urinaire; ambulatoire Résumé But de ... more MOTS CLÉS Cystoscopie; endoscopie; symptômes du bas appareil urinaire; ambulatoire Résumé But de l'étude : Déterminer le profil des patients ayant subi une urétrocystoscopie et d'en décrire les indications, résultats et les gestes complémentaires réalisés. Patients et méthodes : Il s'agit d'une étude descriptive rétrospective des patients ayant subi une urétrocystoscopie en ambulatoire au service d'Urologie et Andrologie de l'Hôpital Général Grand Yoff de Dakar. Les caractéristiques démographiques des patients, les indications, les résultats et les gestes complémentaires de l'examen ont été saisis et analysées dans Epi Info 7 version 3.5.3. Nous avons fait des statistiques descriptives. Résultats : Sur 655 patients ayant subi une urétrocystoscopie, il y'avait 403 hommes et 252 femmes (sex ratio:1,6). L'âge moyen des patients était de 47,44 ans et 27,94% des patients étaient dans la tranche d'âge [40-60 ans]. Les principales indications de l'examen étaient l'hématurie (31,49%), les troubles urinaires du bas appareil (26,44%). Les résultats étaient dominés par les tumeurs de vessie (18,2%), l'hypertrophie prostatique (12,4%), les cystopathies (8,2%) et les lésions bilharziennes (8,1%). Une tumeur de vessie a été trouvée dans 26,45% des cas d'hématurie. Conclusion : L'urétroystoscopie est un examen important surtout en pathologie tumorale. L'hématurie en était la principale indication mettant en évidence surtout les tumeurs de vessie et l'hypertrophie prostatique mais aussi les pathologies inflammatoires de la vessie.
Primary tumors of the upper urinary tract are rarely reported in the literature. We thus report h... more Primary tumors of the upper urinary tract are rarely reported in the literature. We thus report here four cases of primary tumors of the upper urinary tract that were difficult to diagnose, in three women and one man. Preoperative diagnosis was established in only two cases requiring a nephro-ureterectomy. The other two cases were surprisingly diagnosed during anatomopathological examination. Preoperative diagnosis was a pyonephrosis in one case and a renal failure resulting from stenosis of the pelvic ureter in the other. Despite modern methods, primary tumors of the upper urinary tract remain difficult to diagnose.
Prostate cancer is the leading male cancer worldwide. While there are abundant data on the epidem... more Prostate cancer is the leading male cancer worldwide. While there are abundant data on the epidemiology, natural history, treatment and outcomes of the disease in the US and many developed countries, prostate cancer is a good example of cancer disparity in that a little is known about the disease in Sub Saharan Africa. Because of the dominant black race in this region and the fact that black men suffer the higher burden of the disease, it is important to understand that cancer in this population. The purpose of this review is to describe the literature of prostate cancer in Sub Saharan Africa. The authors reviewed the published studies on prostate cancer in Sub Saharan Africa available on PubMed. In addition any other accessible study on the topic was included.
Bothrops asper inflicts the majority of snakebites in Central America and in the northern regions... more Bothrops asper inflicts the majority of snakebites in Central America and in the northern regions of South America, mostly affecting young agricultural workers in rural settings. This species is capable of provoking severe envenomings associated with local and systemic manifestations. The main clinical features are: local edema, ecchymoses, blisters, dermonecrosis, myonecrosis, defibrinogenation, thrombocytopenia, systemic bleeding, hypotension and renal alterations. In addition, soft-tissue infection, acute renal failure, compartmental syndrome, central nervous system hemorrhage and, in pregnant women, abortion, fetal wastage and abruptio placentae have been described as complications. Intravenous administration of antivenom constitutes the mainstay in the therapy. Antivenoms composed of either whole IgG or F(ab 0) 2 fragments, manufactured in Brazil, Colombia, Costa Rica and Mexico, have been tested in controlled clinical trials, and rational protocols for antivenom administration have been developed. In addition to antivenom therapy, a number of ancillary interventions are recommended in the treatment of B. asper bites.
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