Inadequacies were found in clinical documentation, especially gross underutilization of discharge summary forms. However, some forms were properly documented, suggesting that hospital healthcare providers possess the necessary skills for quality clinical documentation but lack the will. There is a need to institute a clinical documentation improvement program and promote quality clinical documentation among staff.

Sub-Saharan Africa (SSA) comprises the countries in Africa that do not have a Mediterranean coastline. This region is home to over 600 million people, most of whom are women and children/young adults who live in the rural areas. Most SSA countries are 'poor' and have low average life expectancy. The subcontinent has a low density health workforce and they are required to provide their services mostly under difficult circumstances. Not surprisingly they are the most likely to migrate to greener pastures. Healthcare provision in general is therefore a challenge in this region and urology is no exception. This article explores some of the more significant challenges facing urological practice and training in SSA. These include those challenges to healthcare practice in general (political instability, poverty, poor healthcare and family planning policies and HIV/AIDS) and those to urology specifically (limited number of trained urologists, limited training capacity, limited availability of modern equipment and drugs, nonrecognition of men's health as a subspecialty). Brief suggestions to overcome these problems are made and the need for a wholesome review of the political, economic and healthcare policies is emphasised.

Early retrograde endoscopic realignment under caudal analgesia is suitable and cost-effective for patients with acute traumatic urethral disruptions and has good medium-term results. In addition, an early postoperative regimen of CIC significantly reduced stricture-formation in our series.