Background Even though, one of the managements options of urethral stricture, popular among the urologists in view of its simplicity, safety and shorter learning curve is Optical Internal Urethrotomy (OIU), urethroplasty should be offered as the gold standard treatment option for urethral stricture. The main aim of our study is to determine the one-year recurrence rate of urethral stricture after treatment with optical urethrotomy and identify predicting factors of urethral stricture recurrence at a tertiary centre in Ethiopia. Materials and Methods A prospective observational cohort study was conducted on 80 male patients who underwent optical urethrotomy for urethral stricture from November 2019 to August 2020 G.C. in a tertiary center in Ethiopia. Logistic regression was used to analyze the association between dependent and independent variables. A p-value of <0.05 was considered statistically significant. Results The mean age (± SD) of patients at the time of the procedure was 54.76 (± 14.74) years with a range [20-78]. Urethral discharge was the most common etiology identified in 39 (48.75%) of patients. Eleven (13.75%) patients had no identifiable etiology for their urethral stricture disease. Majority of patients presented with at least one voiding lower urinary tract symptoms (LUTS). Sixty-eight (85%) patients out of the total had single stricture and 12 (15%) had multiple strictures. The location of stricture was in the bulbar urethra on CUG in 83% of the patients. The one-year recurrence rate of urethral stricture after optical urethrotomy was 35%in our study. Number of strictures and presence of hypertension were independent predictors of recurrence of urethral stricture within one year after treatment with optical urethrotomy [AOR=15.35(2.92-80.61) at 95% CI; P=0.00] and [AOR=19.47(2.11-178.98) at 95% CI; P=0.01], respectively. Conclusions Our study identified that multiplestrictures, and presence of hypertension are associated with increased recurrence rate in the first post-operative year.
Intrauterine device (IUD) is the second most widely used method of contraception worldwide. Up to 14% women prefer IUD for its attractive advantages such as cost effectiveness, high efficiency, and low complication rate. Despite these advantages, however, some complications may occur. One of these complications is uterine perforation and migration of the device to involve adjacent viscera such as peritoneum, bowel, vessels, and rarely bladder. IUD migration into the urinary bladder is uncommon, and only 70 cases are reported in the literature. Recurrent urinary tract infection and bladder calculi are the commonest presentations, and, rarely, women can present with gross hematuria. A high index of suspicion is needed in the evaluation of women who report pregnancy after IUD insertion as it might be the first clue to suspect migration. A forgotten and long-standing IUD increases the risk of uterine perforation and migration. A routine abdominal radiography, cystoscopy, and transvaginal ultrasonography are diagnostic. A computed tomography can also be employed in selected cases to delineate anatomic relations. Urologists should consider a vesical foreign body such as migrated IUD in women with recurrent lower urinary infections. Gross hematuria in a young woman should alert the urologist, and the evaluation should address a detailed contraceptive history. Every migrated IUD should be removed via endoscopy, laparoscopy, or open surgery. Proper follow-up and education of women before and after IUD insertion is also recommended to pick up on complications in time. Here, we report the successful open surgical treatment of a woman who had a forgotten IUD for 15 years and ultimately presented with gross hematuria due to trans-vesical migration. As to our literature search, there was no similar case reported from a urology center from Ethiopia.
The prostatic cysts are uncommon lesions usually detected incidentally. The incidence is reported as less than 1% most often occurs as small & asymptomatic lesions located medially in the gland, when they get a big size causes different lower urinary tract symptoms. Only 5% are symptomatic. The symptoms depend on the size & location of the lesion. Minimal access surgery (endoscopic) is recommended for its treatment. We present a case with the diagnosis of Prostatic cyst at the bladder neck treated with transurethral resection of the lesion. Histopathological investigation revealed benign prostatic cyst. At six months of follow up the patient remains free of symptoms.
Supernumerary kidney is a rare anomaly of number where commonly a third extra kidney exists with its own collecting system, blood supply, and encapsulated parenchyma. However, an extremely rare and unique diagnosis of bilateral supernumerary kidneys is also reported in few instances where two extra kidneys exist on each side of the body. Parenchymal fusion and the presence of good excretory function make the supernumerary kidneys even rarer as many of the reported cases are rudimentary organs. We present a 35-year-old man with a sudden onset of agonizing right flank pain and tenderness. Radiologic assessment with computed tomography showed bilaterally fussed and malrotated supernumerary kidneys with an obstructive stone and good contrast uptake. The patient has four fully functional kidneys (two on each side) with their own arterial supply, venous drainage, collecting system and incompletely duplicated ureters bilaterally. An open pyelolithotomy is performed to relieve pain and hydronephrosis. The patient's symptoms improved after surgery and during subsequent follow-up.
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