Many small low rectovaginal fistulas represent incompletely healed (third degree) perineal lacerations i. e., involving the sphincters. An individualized, systematic approach to these fistulas based on their size, location, and etiology provides a more concise treatment plan. We report a case of a low rectovaginal fistula developed some years following forceps vaginal delivery. This was managed successfully by a fistulotomy in which the bridge of skin and scar tissue was divided, and the defect repaired as a classical third degree perineal laceration. On the background of coexisting or occult sphincter damage which usually follows obstetric trauma, a fistulotomy and immediate composite repair for small, low rectovaginal fistula may be advantageous and acceptable in a low resource setting where endoanal imaging and manometry are not available.

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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.

Objectives: Our study aimed to determine the relationship between the initial total prostate-specific antigen (PSA), PSA density, and aggressiveness of prostate cancer (PCa) based on the new Gleason grade group in the two specialized urology centers in Cameroon. Method: A seven-year retrospective study was conducted from January 2012 to December 2019. The study concerned all men diagnosed with PCa graded using the novel Gleason grade group. Data were analyzed descriptively and analytically using Statistical Package for Social Sciences (SPSS) version 20.0. Bivariate analysis was done to identify independent associations. Results: A total of 253 files were reviewed; fulfilling the inclusion criteria. The mean age of our study population was 66.62±8.288 years with the most affected age being those aged between 59-69 years. The commonest finding on DRE was a hard-craggy prostate (46.0%). The mean initial total PSA was 98.78 ng/dL ± 300.17 ng/mL, while the mean PSA density was 1.73 ± 5.94ng/mL². Gleason grade group 2 was the commonest grade (30.6%). There was a positive correlation between initial total PSA and Gleason grade group (r = 0.314 (p-value 0.000)), and between PSA density and Gleason grade group (r = 0.919 (p-value 0.000)). Initial total PSA and the Gleason grade groups were independently associated with the radiological tumour stage (p-value 0.000 and p-value 0.03 respectively). Conclusion: There is a positive correlation between initial total PSA, PSA density, and novel Gleason grade group. We, therefore, recommend that more attention should be placed on PSA density in pre-biopsy decisionmaking. This study enhances the stratification of therapeutic protocols for the management of PCa in Cameroon as well as across African Union member states.