Objective Intravesical prostatic protrusion (IPP) is a noninvasive parameter that can predict disease progression and development of complications in benign prostatic hyperplasia (BPH). This study was to determine the relationship between IPP and the presence of complications in BPH patients. Methods This was a cross‐sectional study of BPH patients at Enugu State University of Science and Technology Teaching Hospital, Enugu. Patients were assessed for acute urinary retention (AUR), chronic urinary retention (CUR), epididymoorchitis, hematuria, hernia, urinary tract infection (UTI), serum creatinine, and prostate‐specific antigen (PSA). They also had abdominal ultrasonography assessments for IPP, total prostate volume, bladder wall thickness (BWT), postvoid residual (PVR), hydronephrosis, bladder diverticulum, and urolithiasis using Sonoscape S11 with an abdominal‐probe frequency of 3.5 MHz. IPP was measured in millimeter and divided into <10 mm and ≥10 mm. Data were analyzed using SPSS version 21 and were subjected to 1‐way analysis of variance, chi‐square test, and Pearson correlation. The odds ratios of development of complications at an IPP cutoff of 10 mm were calculated. P < .05 was considered significant. Results A total of 118 patients with a mean age of 64.18 ± 10.96 years and a mean IPP of 14.29 ± 10.20 mm were included. Forty‐eight patients had IPP < 10 mm and seventy patients ≥10 mm. Patients with IPP ≥10 mm had significantly higher mean BWT, International Prostate Symptom Score (IPSS), PSA, and PVR (P ≤ .05) and significantly more AUR, CUR, hematuria, hydronephrosis, and UTI (P ≤ .01). Conclusion Patients with IPP ≥ 10 mm have a significantly higher incidence of some complications.

Prostate cancer remains the most common noncutaneous cancer in men, especially in this era of prostate-specific antigen assay. Prostate cancer metastases have been known to commonly affect the lymphatics, bones, and lungs. Prostate cancer metastasis to the skin is very rare (<1%) and often signifies a terminal disease. Involvement of the skin has been thought to be through lymphatic spread by embolization or permeation, hematogenous spread, and implantation during surgery (port site in radical prostatectomy). We report a 74-year-old man on management for advanced prostate cancer with subcutaneous goserelin (Zoladex) but developed skin metastasis in the course of treatment. The skin metastasis in our patient, however, was initially localized to the site of the regions of subcutaneous goserelin injection that we imagined if there is a link between the two. We reviewed the literature and currently found no connection. Is there truly a link?

Introduction: Prostate cancer has an increasing global burden. The clinical course varies from an indolent disease to a rapidly aggressive cancer. It is associated with higher mortality in less developed nations due to late presentation. The Gleason scoring system for prostatic adenocarcinoma has prognostic implications in diagnosed cases. Obesity has been associated with the evolution of many cancers including prostate cancer. There are conflicting reports on the relationship between obesity, as measured by body mass index (BMI), and prostate cancer aggressiveness, as measured by Gleason score. This study is aimed to determine if a correlation exists between BMI and Gleason score in men with prostate cancer. Methodology: This was a prospective, hospital-based, cross-sectional study involving consecutive patients with prostate cancer. Clinical evaluation including anthropometry, digital rectal examination, and relevant investigations were done for each patient and data collected with pro forma. This was followed by prostate needle biopsy and those diagnosed with adenocarcinoma of the prostate had their Gleason grades and scores obtained. Data were analyzed statistically using Spearman Correlation. Results: The mean age of the patients was 69.54 ± 8.61 years (range 47–83 years). The BMI ranged from 16.98 to 36.45 kg/m 2 , with a mean of 27.03 ± 5.03 kg/m 2 . Twenty-six of the patients (36.1%) were overweight and 34.7% were obese. The mean total prostate-specific antigen was 118.65 ± 84.43 ng/ml, with a range of 31–406 ng/ml. The modal Gleason score was 9 with a range of 4–10. There was a strong positive correlation between BMI and Gleason score ( r = 0.817, P = 0.0003). Conclusion: The BMI of patients with prostate cancer correlated positively with their Gleason score.

Introduction: Health-care research in Nigeria has been growing over the years but is constrained by many difficulties. This study aimed to identify the challenges encountered in health-care research and suggest policies to address these problems. Materials and Methods: It was a cross-sectional study of medical doctors who have been involved in health-related researches. All participants filled a self-administered online questionnaire comprising 31 questions in five sections. The responses were analyzed using the Google forms and the Statistical Package for the Social Sciences software version 23. Results: The mean age of the study participants was 41.0 ± 8.4 years. Three-quarters of the respondents (75.5%) worked in teaching hospitals. Nearly all (96.6%) carried out their studies using personal funds and only one in 10 had been involved in high-budget projects (≥₦1,000,000). The generation of quality researches was impeded by the restriction of literature review to free online journals (93.2%), incomplete health records (88.0%), limited access to research kits (65.7%), limited use of advanced statistical analysis (29.8%), and challenges with obtaining ethical approval (21.2%). Despite the average online visibility of these researches (52.2%), only 28.5% stated that it has been locally adopted to influence medical practice in their center. Conclusion: There is a wide disparity in research capacity among hospital tiers. It is important to leverage on and expand existing partnerships to provide institutional access to premium literature, offer robust, and assessable financial support for the conduct of high-quality researches and provide a framework to bridge the gap in the use of these works to influence practice change in Nigeria.

Direct visual internal urethrotomy (DVIU) is a minimally invasive treatment for urethral stricture and is usually done in lithotomy position. We presented a case of a 35-year-old man with complex deformities of both lower limbs from birth. The lower limbs were severely wasted with ankylosis of the hips, flexion of the knee joints and dorsiflexion at the ankle joints. He had a history of progressively worsening difficult in urination characterized by frequency, urgency, urgency incontinence, nocturia, poor urinary stream (improved by straining), intermittency and feeling of incomplete bladder emptying. He had occasional dysuria and total hematuria. He was not a known hypertensive or diabetic patient. No history of trauma, previous urethral instrumentation, and no history of purulent urethral discharge before the onset of problems. On presentation, his abdomen was full with slight suprapubic distention. The anal sphincter was spastic and the prostate was not enlarged. He had normal non-circumcised male external genitalia. There was no spinal deformity and the upper limbs were normal. White cell count was 14,000 cells/ mm3 with a differential neutrophil of 85.5% and urine culture showed moderate growth of coliforms. Abdominopelvic ultrasound showed a thickened bladder wall with mild hydronephrosis bilaterally and a retrograde urethrography and micturating cystourethrography showed 3 short segment bulbar urethral strictures. There was also a Christmas tree appearance of the bladder. A diagnosis of bladder outlet obstruction secondary to multiple short segment idiopathic bulbar urethral strictures on background neurogenic bladder was made. He had intravenous antibiotics for 48 hours and subsequently a DVIU under spinal anesthesia and in the supine position. Catheter was removed on the 7th day post procedure and he started clean intermittent catheterization (CIC) with 12 French catheters. Seven months post procedure, patient is still satisfied with the outcome of his treatment. We concluded that DVIU can be done safely in the supine position and CIC can help improve post procedure outcome and in managing comorbid neurogenic bladder.

Introduction: Available literature suggests an association between Lower Urinary Tract Symptoms (LUTS) and sexual dysfunction especially Erectile Dysfunction (ED). LUTS, either alone or in combination with ED, represents a considerable problem for ageing men. An understanding of correlation between LUTS and ED in these ageing men will be useful in their routine care. Aim: To determine the incidence of ED and its correlation with LUTS in adult male patients attending the Urology clinic in a Tertiary Care Hospital. Materials and Methods: This was a cross-sectional study of 110 consecutive patients with LUTS recruited from the urological clinic. The data were collected, while ED and LUTS were assessed with the 5-Item Version of the International Index of Erectile Function (IIEF-5) and International Prostate Symptom Score (IPSS) questionnaire forms respectively. Findings were subjected to linear regression and Pearson’s chi-square tests, using Statistical Package for Social Sciences (SPSS) version 17. Results: The mean age of patients was 65.8±7.95 years. The incidence of ED among LUTS patients was 63.6%. There was positive correlation between ED scores and voiding phase, filling-storage phase and total LUTS scores. The severity of ED and graded LUTS score revealed no significant association between the severity of ED and that of voiding phase and filling-storage phase LUTS. Conversely, severity of ED was significantly related to the severity of total LUTS score. Conclusion: ED is common amongst adult patients with LUTS. Its severity worsens with worsening LUTS. The management of patients with LUTS should therefore involve evaluation and treatment for ED. This calls for increased awareness of these conditions to both the doctor and the patient.

Introduction: Bladder Outlet Obstruction (BOO) due to prostate- related diseases can lead to changes in bladder wall resulting in detrusor wall thickening. These changes are time-dependent and may reflect the severity of underlying BOO. Although urodynamic tests are considered to be the gold standard for the assessment of the severity of Lower Urinary Tract Symptoms (LUTS), these are time-consuming, invasive and expensive. The Detrusor Wall Thickness (DWT) measurement has emerged as a cheap, non invasive and reproducible alternative means of assessing the severity of LUTS in men with BOO. Aim: To determine the correlation between the DWT and International Prostate Symptom Score (IPSS) in men being evaluated for prostate-related BOO/LUTS. Materials and Methods: A cross-sectional hospital based study was conducted over a period of 12 months (May 2014 to April 2015), at Urology Clinics of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. All 100 new consecutive male patients aged ≥40 years with prostate-related LUTS and who can achieve bladder volume of >250 mL were included in the study. The DWT was measured at three different sites (anterior, lateral and dome) at bladder volume >250 mL. Ethical approval was attained from the institutional ethical review board. Severity of LUTS was assessed using a validated IPSS questionnaire. Data was analysed using SPSS version 20. Spearman’s correlation was used to assess the correlation. The p-value <0.05 was considered significant. Results: A total of 100 men with the mean age of 71.02±9.10 years were studied. The mean duration of symptoms was 30.63±26.60 months with the average IPSS being 20.94±6.13. A total of 43 patients and 57 patients had moderate and severe LUTS, respectively. None of the patients had mild LUTS. The mean anterior, lateral, dome and average DWT measurements were 4.95±2.36 mm, 4.96±2.37 mm, 5.02±2.34 mm and 4.97±2.35 mm, respectively. A total of 97 patients had DWT ≥2 mm. There was a significant positive correlation between the DWT and IPSS (r2=0.635 and p<0.001). Conclusion: The positive correlation between the DWT and IPSS has demonstrated that the DWT measurement can be used in assessing the severity of LUTS in men with prostate-related diseases.

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