Background: Surgical haematuria is not very common but ominous when it occurs. Knowledge of the causes will help in the adequate management of the disease. Aim: To evaluate the causes of surgical haematuria in Port Harcourt, Nigeria. Materials and Method: This is 10 years retrospective study of patients who presented at the University of Port Harcourt Teaching Hospital and 4 other private urology centres in Port Harcourt with haematuria of surgical aetiology between January 2012 and December 2021. Their history, examination findings and investigations were evaluated. Patients with medical haematuria and incomplete records were excluded from the study. Results: Three hundred and forty-six patients were evaluated. The mean age was 58.12 ± 5.1. Two hundred and sixty-four (76.3%) were men and eighty-two (23.7%) were females. The three commonest causes of haematuria were Benign prostatic enlargement, prostate cancer and urolithiasis with a frequency of 126 (36.41%), 66 (19.08%) and 40 (11.56%) respectively. The cause of haematuria was benign in 232 (67.06%) subjects and malignant in 114 (32.94%). Conclusion: The commonest causes of haematuria are of prostatic origin, mainly benign although malignancy is a significant cause.
Background: Urinary tract infection is a cause of significant morbidity and potential mortality in patients. Urine microscopy culture and sensitivity enable the isolation of the incriminating microbes. The sensitivity and resistance of the various microorganisms are invaluable in the effective management of UTIs and the associated adverse consequences. Gram-negative organisms are the usual pathogens responsible for most UTIs. The abuse of antibiotics can increase the prevalence of antimicrobial resistance. This leads to an increased cost of treatment, as more expensive higher-end antibiotics may become indicated. There is also the risk of spreading multidrug-resistant infections to the community. Aims: To evaluate the sensitivity and resistance patterns of commonly available antibiotics to uropathogens in the positive urine culture of patients who presented with upper and lower urinary obstruction. Methods: This retrospective study was carried out on urine samples of patients with upper/lower urinary obstructive from two specialist urology referral hospitals with a positive culture and sensitivity tests between January 2011 and December 2020. The patients’ case notes were retrieved, and their urine culture, sensitivity results and mode of treatment were analyzed. These data were collated using Microsoft Excel, and they were analysed using SPSS version 20. Results: 314 urine samples had positive culture and sensitivity tests. All were Gram-negatives: Klebsiella, Escherichia coli, Pseudomonas, Proteus and Citrobacter spp. in decreasing frequency. Among the quinolones, levofloxacin {56.7% (178)} had the highest moderate-high (M-H) sensitivity to the Gram-negative uropathogens; followed by Ciprofloxacin {46.2 % (145)} and Ofloxacin {19.1% (60)}. The gram-negatives were most sensitive to streptomycin {75.5% (237)} and gentamicin 62.4% (196)} and also least resistant to them. (Streptomycin 11.1%; gentamicin 21.0%) The highest resistance was to Nalidixic acid {90.1%, (225)}, peflacine {76.1% (239)}, Augmentin {73.6% (231)} and Ampicillin{72%(226)}. Conclusion: Among the commonly available antibiotics in our study, the gram-negative uropathogens are the most sensitive and least resistant to streptomycin, gentamycin and levofloxacin. Levofloxacin had the best sensitivity and lowest quinolones resistance compared to ciprofloxacin and ofloxacin. There is very low sensitivity and high resistance to nalidixic acid, ampicillin, Augmentin, Septrin and Peflacine.
Background: Circumcision is the removal of the fore skin of the penis. It is one of the commonest operations performed worldwide. Meatal stenosis is an uncommon long-term complication of circumcision that can lead to problems voiding. Aim: To identify the clinical presentations and management of meatal stenosis in Port Harcourt. Materials and Methods: This was a retrospective study of patients who presented with features of meatal stenosis between January 2012 and December 2021. The patients' history, physical examination findings, investigations and treatment received were analysed. Results: A total of 52 patients with features of meatal stenosis were recruited for the study. The number of patients less than a year old, between a year and 5 years, between 6 and 10 years and greater than 11 years were 8, 12, 28 and 4 respectively. Only 8 patients presented within 6 months of onset of symptoms. The most common symptom was poor urine stream, followed by straining. Meatotomy was the most commonly performed procedure for meatal stenosis 24 (46.15%). The patients were followed up for at least 6 months. Six patients had recurrence after treatment of meatal stenosis. Three patients each had a recurrence following dilatation and meatotomy. No patient had recurrence after meatoplasty. Conclusion: Meatal stenosis is an uncommon complication post circumcision. Patients usually present late to the hospital in our study. Meatoplasty had the best outcome. After treatment of meatal stenosis patients should be followed up for 6 months.
Background: Prostate cancer (PCa) may be asymptomatic at an early stage and may run an indolent course that requires minimal or no treatment. Early diagnosis through screening reduces the rate of advanced diseases. Whereas, in the western countries where screening is more prevalent, many presents early with a chance for curative treatment. In Africa, late presentation is often the case with palliative treatment sadly the only choice. Objective: To evaluate the associated complications in patients with prostate cancer and assess the Gleason’s grade as a risk factor for complications observed in patients with prostate cancer, in Port Harcourt, Rivers, Nigeria. Method and Methodology: This was a retrospective study carried out over ten years, between January 2011 and December 2020. All patients with histologically confirmed prostate cancer who presented to the University of Port Harcourt Teaching Hospital, Sophia clinic, and Rosivylle clinic were evaluated. The folders were retrieved and their age, presenting complaints, skeletal survey, and biopsy reports were evaluated. Patients with incomplete records were excluded from the study. These data were collated using Microsoft Excel 2016 version and they were analyzed using SPSS version 20. Results: There were 335 patients with PCa with a mean age of 68.71year. The commonest complication was urinary symptoms observed in 192 with urine retention 119(35.5%) and nephropathy 73(21.8%). The spine was the commonest site of bone spread observed in 160(47.8%) followed by the femur 62(18.5%). Anaemia was the next common. There was an association between age, presence of urinary symptoms, and bone involvement with the Gleason’s Grade. However, there was a strong association of the overall presence of complications with Gleason’s score. Conclusion: Men with prostate cancer tend to present with advanced disease in Port Harcourt. The most common presentation was lower urinary tract symptoms followed by low back pain. Complications are associated with high Gleason’s grade cancers. Screening may aid in early diagnosis and cure of the disease especially for men of African descent.
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