Background:In parts of Africa, routine circumcision is practised and sometimes even on children with hypospadias. The lack of preputial foreskin renders urethroplasty more difficult and often requires to use of a mucosal graft as described by Bracka.Objective:The authors describe their experience of hypospadias repair using Bracka's technique.Materials and Methods:Over a period of 5 years, 100 cases of proximal hypospadias were operated in our institution. All patients aged 0–18 years who had already been circumcised were included in this study.Results:The outcome of the 12 cases operated according to Bracka's technique was analysed. The mean age was 11.5 years. The ectopic meatus was penoscrotal in three cases, scrotal in one case and perineal in eight cases. After reconstruction, the new meatus was sutured at the top of the glans in one case, at the prepuce in seven cases and at the penile midshaft in one case. The main complications noted were surgical site infection, wound dehiscence, residual chordee and urethrocutaneous fistula. No neourethral stenosis nor uretrocele was recorded.Discussion:The buccal mucosal graft urethroplasty as described by Bracka is associated with a lower risk of meatal strictures compared to other free mucosal grafts. The buccal mucosa is easier to harvest and causes less scarring than bladder mucosa.Conclusion:Repair of severe hypospadias remains a challenge for paediatric surgeons. The functional and cosmetic outcomes depend on the choice of the donor site for the graft and objective assessment of successful reconstruction criteria during follow-up.
Introduction. Urethral strictures in boys denote narrowing of the urethra which can be congenital or acquired. In case of acquired strictures, the etiology is iatrogenic or traumatic and rarely infectious or inflammatory. The aim of this study was to highlight the diagnostic and therapeutic difficulties of acquired nontraumatic urethral strictures in boys in Yaoundé, Cameroon. Methodology. The authors report five cases of nontraumatic urethral strictures managed at the Pediatric Surgery Department of the YGOPH over a two-year period (November 2012–November 2014). In order to confirm the diagnosis of urethral stricture, all patients were assessed with both cystourethrography and urethrocystoscopy. Results. In all the cases the urethra was inflammatory with either a single or multiple strictures. The surgical management included internal urethrotomy (n = 1), urethral dilatation (n = 1), vesicostomy (n = 2), and urethral catheterization (n = 3). With a median follow-up of 8.2 months (4–16 months) all patients remained symptoms-free. Conclusion. The authors report the difficulties encountered in the diagnosis and management of nontraumatic urethral strictures in boys at a tertiary hospital in Yaoundé, Cameroon. The existence of an inflammatory etiology of urethral strictures in boys deserves to be considered.
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.
All patients presented with asymmetrical gonadal differentiation. On one side of the body, a poorly-developed testicular gonad and on the other side a gonadal streak. A persistent Mόllerian remnant was equally found in the 3 cases. Management of mixed gonadal dysgenesis should be done in tertiary health care centres. A multidisciplinary team approach is recommended.
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