ABSTRACT
Contexte et objectifs. L'hydrocèle conduit dans ses formes évoluées à un retentissement psycho-social, économique et anatomique. Les objectifs de l'étude étaient de décrire les aspects cliniques et le devenir sous traitement de l'hydrocèle vaginale de l'adulte (HVA). Méthodes. Etude documentaire descriptive réalisée, au Centre hospitalier régional Amadou Sakhir Mbaye (CHRASM) de Louga, Sénégal ayant enrôlé des patients de 19 ans et plus présentant une hydrocèle, opérée selon la même technique entre janvier 2011 et décembre 2017. L'opération a consisté en une résection de la vaginale à 0,5 cm du testicule suivi d'hémostase au bistouri électrique, sans surjet hémostatique. Résultats. 1538 patients ont été opérés dont 69 pour HVA (4,5 %) et trente-neuf (n=39) d'entre eux étaient retenus. Leur âge moyen était 61,7 ± 21,3 ans. Le principal motif de consultation était : l'aspect volumineux et inesthétique des bourses. Un total de 48 unités d'hydrocèle ont été opérées : droites (n=19), gauches (n=11) et bilatérales (n=9). La vaginale était épaissie pour l'ensemble des cas. Les suites opératoires ont été simples. Aucun décès. À six mois, les patients étaient satisfaits, aucune récidive. Conclusion. HVA est une pathologie relativement courante dans notre pratique. La résection de la vaginale avec hémostase au bistouri électrique sans surjet hémostatique est une technique sûre et efficace
Context and objectives. Adult hydrocele is a relatively common pathology that causes psychosocial, economic and anatomical repercussions. The objectives of this study were to describe the clinical features and the outcome of hydrocele. Methods. This retrospective study included adults operated for hydrocele, in the Department of Urology of Louga Hospital, from January 2011 to December 2017. The operation begins by a scrotal skin incision that is carried down to the parietal tunica vaginalis which is opened and the content aspirated. Parietal tunica vaginalis is excised. Hemostasis is achieved by only electrocoagulation. Testicle is reintegrated, the wound closed without drain and protected by the dressing. Results. 1538 patients underwent surgery including 69 patients (4.5 %) for adult hydrocele. However, 39 out of these 69 patients (61.7 ± 21.3 years) were enrolled in the present study. Thirty-five were married and the others were unmarried (n=4). The main complaints for patients were inesthetic and scrotal swelling, interference and difficulties in socio-professional activities, negative social comments. The mean duration of the hydrocele evolution was 4 years. Operation procedures were done under spinal (n=38) or general anesthesia (n=1). A total of 48 hydroceles were cured including 11 on the left side, 19 on the right side and 9 bilateral. The mean volume aspirated was 600 ml. The tunica vaginalis was thick in all cases and calcified in 15 cases of hydrocele. No complications (hematoma or wound infection) were observed. No deaths or recurrences were recorded. Six months following the surgery, all patients were satisfied. Conclusion. Adult hydrocele is relatively common in the Department of Urology of Louga Hospital. The treatment consisting in excision of the tunica vaginalis, hemostasis by electrocoagulation, without hemostatic running suture is safe, secure and effective.
Subject(s)
Humans , Hemostatics , Adult , Testicular Hydrocele , Senegal , TherapeuticsABSTRACT
Background: Prothrombin time (PT) and activated partial thromboplastin time (APTT) are the tests used in the investigation and monitoring of hemostatic disorders. Plasma is used to perform these tests immediately or stored for later use. The time and storage temperature have been shown to affect the results of these tests. Thus; all coagulation laboratories need guidelines for plasma storage to ensure reliable results. Objective: To determine the effect of varying storage times and temperatures on plasma PT and APTT. Materials and Methods: PT and APTT were run on plasma from 40 healthy adults using a semi-automated coagulometer. PT and APTT were measured at 0; 4; 6; and 24 h on samples stored at room temperature; refrigerated samples; and frozen samples. The values at 0 h were compared with the values at 4; 6; and 24 h. Results: PT and APTT values were within the reference ranges at 0 h. For refrigerated plasma; PT values at 4 h were within normal; but at 6 and 24 h; they were significantly deranged (P 0.05). PT was significantly different at 4; 6; and 24 h for both room temperature and frozen plasma (P 0.05). The APTT showed significant differences between 0 h value and values at 4; 6; and 24 h for all the varying temperature conditions. Conclusion: For reliable PT and APTT results; samples should be processed and run immediately after collection. However; plasma for PT can be stored at 2o-4oC for only 4 h