Objective: To study the epidemiological, diagnostic and therapeutic profile of kidney tumors in adults over the past five years. Patients and methods: This was a retrospective, descriptive and analytical Study from the 1 st of January 2014 to 31 st of December 2018. All patients aged 18 years or older hospitalized, followed or operated in the service for a kidney tumor were included in the serie. The parameters studied were: epidemiological, clinical and paraclinical aspects, TNM stage (2017), treatment, histological type, evolution and survival. The calculation of survival rate was done with SPSS IBM statistics 24. Results: sixty-seven patients were included. The average annual incidence was 13. The average age of the patients was 49.6±15.6 years. The sex-ratio was 1.2. Hypertension, smoking and obesity were the main risk factors found. The average size of the tumor was 7.7±4.40 cm. The left kidney location was more frequent. Thirteen patients (20%) had a localized tumor in the kidney, twenty patients (31%) had locally advanced cancer and thirty two patients (49%) had metastasized cancer. Forty-seven patients (70%) had surgical treatment, including five patients with an anti-angiogenic adjuvant therapy. Twelve (17.9%) patients had an antiangiogenic therapy only. Clear cell carcinoma was the most common histology type. The overall survival (OS) rate for cancer patients at 2 years was 22% for surgical treatment, 8% for medical treatment. Conclusion: this work reveals that adult kidney cancer affects young adult and is discovered at advanced stages without any significant change in the epidemiological and clinical profile of these cancers during the two decades.
Purpose: To describe the clinical-pathological profile of sequelae of urogenital schistosomiasis. Patients and methods: We performed a retrospective study of the sequelae for cases of urogenital schistosomiasis treated between January 2011 and December 2016. These cases were from Senegal and neighboring countries. Results: We included 43 cases. The mean age of the patients was 43.2 ± 16.6 years (14 -75 years). The sex ratio was 3.3. The sites of the sequelae lesions were the bladder and pelvic ureters in 83.7%, the bladder only in 13.9%, and the ureters only in 2.3% of the patients. Bladder wall calcification was the most common lesion (74.4%), followed by bladder masses (48.8%). Stenosis of the orifice was the most common ureteral lesion (30.2%). The bladder masses were a squamous cell carcinoma in ten cases, a urothelial carcinoma in one case, and a schistosomiasis granuloma in five cases. In one patient, the histological type was not specified. Of the ten cases of squamous cell carcinoma, eight had died of cancer. Of the twelve cases of ureteral orifice stenosis treated by ureterocystoneostomy, the outcome was good in nine cases and poor in three patients. Conclusion: In this study, sequelae of urogenital schistosomiasis were most often observed in young adult males. The most common sequelae were vesical and ureteral calcifications, bladder cancers, and pelvic ureter strictures.
Aim: To report the epidemiological and diagnostic aspects and evaluate the management of urological emergency in a university hospital. Patients and method: We conducted a single-center retrospective descriptive study over the period January 2015 to December 2017. We collected medical records of patients with urological emergency referred by the urology care team in our center. Results: Three hundred patients were identified over a period of 36 months. The mean age of the patients was 47.8±22.9 years (2 years -92 years). The sex-ratio was 10.5. The most common emergency was haematuria (25.6%) and urinary retention (21.6%). Urogenital infections were noted in 19% of patients mostly scrotal cellulitis (10%) and acute pyelonephritis (3.6%). The number of emergency hospitalization was 230 (76.7%). We performed 143 emergency surgical procedures (47.6%). The overall mortality rate was 1%. Conclusion: Urological emergency were dominated in our context by hematuria and urinary retention occurring most often in young adults. However, infectious and lithiasic diseases remain common conditions.
Objective: To evaluate the clinical and therapeutic aspects of male subfertility in the Region of Thies. Patients and methods: This is a retrospective and analytical study involving patients followed for subfertility over a period of 4 years from January 2013 to November 2017 at the level of 3 health structures in the region of Thies. Results: During the period, we collected 201 patients. The average age was 38 ± 8.4 years with a greater distribution in the age group 30-39 years. Primary subfertility was predominant with 81.1% of cases. The average duration was 5 years. We found a history of urethritis (4%) and orchiepididymitis (2.5%). Thirty-three percent of patients presented a varicocele (67 cases). Cryptorchidism was recorded in 2% of cases, testicular hypotrophy in 18.4% and testicular atrophy in 1.5%. The spermogram identified oligospermia-like abnormalities in 40.8% of cases, azoospermia 22.4%, and hypospermia 4%. For the qualitative abnormalities, we recorded cases of asthenospermia in 60.2% of the cases or 121 patients, a necrospermia 58.2% and a teratospermia 20.4%. A combination of these abnormalities was also reported as astheno-necrospermia in 19.4% of cases, oligo-astheno-necrospermia 14.4%, oligo-asthenotera-necrospermia 10% and oligo astero-teratospermia in 2.5%. An assessment of FSH, LH and testosterone was performed in 5.9% of the cases, or 12 patients. Varicocelectomy was performed in 68.4% of cases 19 patients, and (medically) assisted procreation in 2 patients. We recorded 13 cases of pregnancy. Conclusion: Male hypofertility is a real problem of management, and requires a particular approach.
Introduction: The purpose of this work is to evaluate the epidemiological, clinical and therapeutic aspects of spermatic cord in our context. Patients and Methods: This is a retrospective study over a period of 4 years from January 1, 2014 to June 30, 2018. Results: We collected 55 cases divided into 26 cases, 44.27% for the Thies Regional Hospital, 21% or 38.18% for the Mbour EPS and 8 cases representing 14.55% for the Saint Jean de Dieu Hospital. We found an average age of 20.03 years with extremes of 4 years and 56 years. In 28 patients or 50% of cases, we found no particular pathological history, while in 4 patients or 7.14%, we found a notion of recurrent ipsilateral testicular pain. We recorded 67.27% (n = 37) of the cases received for testicular pain; 15 patients or 27.27% presented a large painful pouch. Two patients (3.64%) were received for inguinal swelling and 1 patient (1.82%) presented testicular atrophy. The average consultation time is 16.9 hours with extremes of 2 hours and 96 hours. The torsion was in 59.61% of cases (n = 32) located on the right versus 40.38% (n = 22) on the left. There was no bilateral form. The pickup time was 3 hours with extremes of 1 h to 24 h. All patients benefited from an exploratory scrotomy. We found a total of 22 patients or 40% of cases with ischemic testis, 8 cases or 14.55% of patients with necrotic testis and 2 cases or 3.64% where the testis was normal. Orchidopexy was performed in 46 patients or 83.63% and orchiectomy in 9 patients. Conclusion: Care is urgent. There is a need for better awareness of the population and the medical staff for the early diagnosis.
Introduction: Obstetric vesico-vaginal fistula is an abnormal communication between the bladder and the vagina as a complication of obstructed labour. The aim of this work is to show the role of ambulatory surgery in the treatment of VVF. Patients and Methods: This is a prospective study over a period of 4 years from 01 January 2011 to 31 December 2014, with 21 cases of VVF patients with simple obstetric outpatient treatment. The average age of patients was 24 years, ranging from 15 to 45 years. The technique used was that of Bracquehaye modified. All patients were kept for a day in hospital without an indwelling urinary catheter. Results: Out of a total of 115 fistula patients, 38 of them had simple VVF representing 33%. Among the simple cases, 21 patients underwent surgical treatment as outpatients, accounting for 55.26%. The average time before surgery was 5 years, with a range ranging of 2 months to 20 years. Of all the simple VVF patients operated on outpatient's basis, we recorded a 90.5% rate of good outcome (n=19). Patients were followed over a period of 1 to 5 years. Conclusion: Obstetric VVF is a public health problem. Ambulatory surgery has advantages in that it reduces the indwelling and hospital stay.
L'éviscération transanale de l'intestin grêle par empalement est exceptionnelle chez l'enfant. Nous rapportons l'observation d'un adolescent de 11 ans reçu à 2 heures d'une issue des anses grêles à travers l'anus suite à une chute avec réception sur un morceau de bois pointu. L'examen clinique avait objectivé un bon état général, une issue, par l'anus, d'environ 25 cm d'intestin grêle viable et un abdomen sensible dans son ensemble. Le bilan biologique préopératoire était normal et aucune imagerie n'était réalisée. Après une réanimation, l'exploration chirurgicale avait mis en évidence un liquide séro-hématique (300 ml) et une issue d'environ 60 cm d'anse grêle inflammatoire à travers une brèche d'environ 5 cm de la paroi antérieure du rectum. Une réduction des anses grêles éviscérées par traction douce, une réparation de la paroi rectale par des points séparés, une toilette et un drainage ont été réalisés. Le patient était sous antibiotique à large spectre. Les suites opératoires étaient simples avec une reprise du transit à J2 post-opératoire. La sortie a été autorisée à J7 post opératoire. Après un recul d'un mois, la patiente a été revue en consultation et l'examen clinique était normal.
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