Endourology in a Nigerian Tertiary Hospital – current level of practice and challenges

Salako, AA; Badmus, TA; Sowande, OA; Adeyemi, B. A.; Nasir, AA; Adejuyigbe, O

doi:10.4314/njsr.v7i3.12293

Cited by 4 publications

(7 citation statements)

References 3 publications

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“…Our commonest diagnostic indication for LUT endoscopy was bladder tumor presenting (31.3%), this could be due to very high number of bladder tumor cases we see particularly in the northern part of Nigeria as compared to the south, studies in the southern Nigeria revealed commonest indications as bladder outlet obstruction from prostate enlargement. 3,4,8,9 Another studies by Mwashambwa et al in Tanzania revealed haematuria as the commonest indication, but even in their studies, 66% of these patients with haematuria were later found to have bladder tumor. 10 Our second leading indication was removal of double J stents by urethrocystoscopy.…”

Section: Discussionmentioning

confidence: 97%

“…The commonest procedure in our series was urethrocystoscopy, which were done for both diagnostic and therapeutic purposes (either for biopsy of bladder tumor, removal or insertion of double J stents, bleeding BPH, removal of foreign body and assessment of incontinence with contracted bladder as shown in table 2), similar observations were made in many centres in Nigeria, this is not a surprise because urethrocystoscopy, is the easiest and first learning curve on endourology to trainee urologists and young urologists. 1,3,4,6,12 In this multicentre study, we used rigid urethroscopes for the endoscopy in both theatres, similar to the multicentre study of Oranusi et al in which they used rigid urethroscopes in all their patients. 13 However, where flexible urethroscope is available as in the study of popoola et al, this procedure can be done conveniently at urology clinics without unnecessary waiting list for surgery.…”

Section: Type Of Anaesthesiamentioning

confidence: 99%

“…3 Endourological practice is low in our country due to deficiency of equipment, personnel, and funding, particularly in the typical public hospitals, and where it is readily available at private practice, the average Nigerian cannot afford the exuberant cost of this services at private setting. 4 Anatomically, the lower urinary tract (LUT) comprises of the bladder and urethra in both sex. Although the prostate and seminal vesicles in the male are not strictly involved in the conduction of urine from the bladder to the exterior, but due to their intimate relation with male urethra (both topographically and functionally), they are conventionally regarded as part of lower urinary tract in the male.…”

Section: Introductionmentioning

confidence: 99%

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Audit of lower urinary tract endoscopic procedures in Borno, North-Eastern Nigeria

et al. 2021

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Background: Endourology which includes lower urinary tract (LUT) endoscopy, is an important component of standard urological practice worldwide. The objective of our study was to audit the LUT endoscopic procedures performed in Borno, a state in north-eastern Nigeria and share our experience.Methods: We, retrospectively reviewed the Lower urinary Tract endoscopies performed in Borno state over 9 years, from January 2012 to December 2020. Data related to LUT endoscopies were extracted from the patients’ clinical notes and operation theatre registers of the 2 focused hospitals in Borno where endourology procedures were performed (University of Maiduguri Teaching Hospital and Royal specialist hospital maiduguri) and then analyzed. Urology patients who did not undergone LUT endoscopy were excluded.Results: We analyzed the data of total sum of 201 patients for the 2 hospitals, which represented the sample size for the study. Mean age of patients was 47.2years, with male to female ratio of 3.5:1. Bladder tumor with or without haematuria (31.3%) was the commonest indication for LUT endoscopy, seconded by removal of ureteric double J stents (23.4%). Urethrocystoscopy (74.0%) was the commonest procedure performed predominantly under local anaesthesia, for both diagnostic and therapeutic purposes.Conclusions: We reported LUT endoscopies in Borno which was commonly indicated in bladder tumors presenting with or without haematuria. Urethrocystoscopy is the commonest procedure. As we get more endourology equipment in the public hospital many of our patients will benefit from these minimally invasive procedures in both lower and upper urinary tract diseases.

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Section: Discussionmentioning

confidence: 97%

Section: Type Of Anaesthesiamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Audit of lower urinary tract endoscopic procedures in Borno, North-Eastern Nigeria

et al. 2021

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“…A tabulation of our findings from a search of English publication on endourological procedures in the sub region ( Table 1) confirmed the paucity of endourological procedures for the treatment of upper urinary tract pathologies in the West African sub-region. This calls for efforts at training and increasing access to endourology equipment and services to improve the management of upper urinary pathologies including calculi as occurs in the cases of forgotten ureteral stents [31]- [34].…”

Section: Discussionmentioning

confidence: 99%

Forgotten Ureteral Stents in a Tertiary Hospital in Accra and a Review of Endourological Management of Upper Urinary Tract Pathologies in the West Africa Sub-Region

Bray¹,

Kyei²,

Mensah³

et al. 2016

OJU

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Background: Forgotten ureteral stent is defined as prolong indwelling ureteral stent whose function is no longer desired. Ureteral stents are used in the management of upper urinary tract pathologies. Prolonged indwelling ureteral stents may be complicated by urosepsis or renal failure, encrustation, stone formation, spontaneous fracture which may either be retained or voided in the urine (stenturia). Hitherto, these complications were managed by open procedures alone in our center. We report our recent experience in endourology with the management of three cases of forgotten ureteral stents with durations of ten years and two years (two cases) and review endourological practice in West Africa. Conclusion: Although encrusted stents can be managed successfully by minimally invasive approaches in the majority of cases, the best treatment is prevention. Urology units should have preferably an electronic stent register such that when the time for removal is due, the patient's name and details are flagged red. If electronic register is not available, then a hard paper/book register should be made to prevent situations of forgotten stents. Also, efforts must be made to improve endourological services in the West Africa sub-region to allow patients to have the benefit of endourology in the management of upper urinary tract pathologies including that of stones originating from an encrusted or fractured forgotten ureteral stent.

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“…Our subregion has lagged far behind in keeping pace with the application of technological innovations in urology. [ 17 18 19 ] However, recently, the use of ureteroscope to treat stone diseases is beginning to make inroads. This study seeks to review our experience with the ureteroscopic management of distal ureteric stones with a view to appraising the stone clearance and the complications seen in our patients.…”

Section: Introductionmentioning

confidence: 99%

Retrograde ureteroscopy in the management of distal ureteric stones: A retrospective analysis of outcome and complications

2020

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Background: Urinary stones affect 8%–15% of the world population. In Nigeria, contemporary reports have shown that the incidence of urinary stones is rising. The distal ureter has been described as the most common location of ureteric stones. This study seeks to review our experience in the ureteroscopic management of distal ureteric stones with a view to appraising the stone clearance rate and the complications seen in our patients. Patients and Methods: This descriptive study reviewed the record of 21 patients, who had semirigid ureteroscopy and pneumatic lithotripsy for distal ureteric stone between October 2015 and September 2018. All patients had computed tomography urography preoperatively to locate the stone. Data on patients' demographics, indication for the surgery, location and size of stone, preoperative double-J (DJ) placement, postoperative DJ stent placement, intraoperative and postoperative complications, and status of stone clearance were retrieved and subjected to statistical analysis. Results: The mean age of the patients was 37.95 ± 11.09 (range, 21–67) years. The mean stone size was 8.06 ± 2.87 mm with a range of 4.8 mm–15.0 mm. Out of the 21 patients, 20 (95.2%) had the procedure for recurrent ureteric colic and 1 (48%) was for hematuria. Four (19.0%) patients had DJ stent preoperatively, whereas 17 (81.0%) patients did not have. Fourteen (66.7%) patients had intraoperative ureteric dilatation. Postoperative DJ stent was placed in 17 (81.0%) patients, whereas 4 (19.0%) patients did not have. Three (14.3%) patients had mucosal flap, 6 (14.3%) had mucosal abrasion, 2 (9.5%) had bleeding, 1 (4.8%) patient had transient hematuria postoperatively, and 2 (9.5%) patients had urinary tract infection. Nineteen (90.5%) patients had complete clearance in a single surgery. Two (9.5%) patients had symptomatic residual fragments that required repeat ureteroscopy. Conclusion: Our study has shown that ureteroscopy is a useful and safe technique in the removal of stones in distal ureter.

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Endourology in a Nigerian Tertiary Hospital – current level of practice and challenges

Cited by 4 publications

References 3 publications

Audit of lower urinary tract endoscopic procedures in Borno, North-Eastern Nigeria

Audit of lower urinary tract endoscopic procedures in Borno, North-Eastern Nigeria

Forgotten Ureteral Stents in a Tertiary Hospital in Accra and a Review of Endourological Management of Upper Urinary Tract Pathologies in the West Africa Sub-Region

Retrograde ureteroscopy in the management of distal ureteric stones: A retrospective analysis of outcome and complications

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