Diagnostic urethrocystoscopy: A five-year review of indications and findings in a tertiary hospital in Nigeria

Background:Urethrocystoscopy is defined as endoscopic visualization of the urethra and the urinary bladder for the purpose of diagnosis or treatment of diseases of the lower urinary tract.Objective: To study the indications, diagnosis and complications of diagnostic urethrocystoscopy in our hospital.Materials and method:It was a retrospective descriptive study of all patients who had diagnostic urethrocystoscopy in our hospital between January 2016 to December 2021. Institutional ethical clearance was obtained. Particulars of the patients were collected from the operating theatre register and their medical case files were retrieved. Information about the patients'bio-data, presentation, clinical/radiologic diagnosis, urethrocystoscopic findings and its complications were extracted. The generated data was analyzed using statistical package for social sciences (SPSS) version 21 and results presented in tables, text and figures.Results:Atotal of 673 patients had urethrocystoscopy/cystoscopy during the period out of which we recovered full medical records of 592 patients whose data were analyzed.The patient's age ranges between 9 to 86years with mean age of 43.7±9.3SD years and M: F = 3.9:1. The indications for diagnostic urethrocystoscopy were lower urinary tract symptoms [LUTS] (48.8%), bladder tumour (29.2%) and haematuria (11.1%) among others. The urethrocystoscopic diagnoses were bladder tumour (37.8%), prostate enlargement (19.1%) and urethral stricture (6.9%) among others. The complications recorded were urethral/bladder bleeding (2.4%), urosepsis (1.4%) and urethral/bladder injury (0.3%).Keywords: Urethrocystoscopy, diagnosis, indicationsConclusion: Urethrocystoscopy is a necessary tool for comprehensive practice of urology owing to its vital role in the diagnosis and treatment of different kinds of lower urinary tract diseases and it is generally a safe procedure

L'ectopie rénale: à propos de 43 cas colligés en milieu hospitalier en Côte d'Ivoire

La présente étude s'est proposé de décrire les caractéristiques de l'ectopie rénale en milieu hospitalier en Côte d'Ivoire afin d'en identifier les particularités. Il s'agissait d'une étude descriptive avec une collecte rétrospective des données des patients hospitalisés et/ou reçus en consultation dans le service de Néphrologie du CHU de Yopougon à Abidjan entre Janvier 1991 et Décembre 2015. Le diagnostic d'ectopie rénale a été posé à l'imagerie médicale devant la présence de structure rénale individualisable en dehors de la fosse lombaire haute. Nous avons relevé 43 cas d'ectopie rénale sur 22 197 dossiers de patients, soit une prévalence de 0,19 %. Le sex-ratio était de 1,5. L'âge moyen des patients était de 35,4 ans. Les circonstances de découverte étaient représentées par les douleurs abdominales (48,84 %). Il s'agissait essentiellement d'ectopie rénale simple (95,35 %) en position pelvienne (74,41 %). L'ectopie rénale croisée a été notée chez deux patients et l'ectopie bilatérale chez quatre dont un cas de fusion en fer à cheval. Un patient avait un rein pelvien associé à une agénésie rénale controlatérale. Quatre cas d'anomalies urologiques ont été observés. L'agénésie utérine et l'ectopie testiculaire étaient les anomalies génitales retrouvées. Les complications étaient essentiellement les douleurs abdominales récidivantes (83,34 %) suivies de l'infection récidivante du tractus urinaire (8,33 %) et la lithiase rénale (8,33 %). L'ectopie rénale représente une entité uro-néphrologique peu fréquente en milieu hospitalier. Ses caractéristiques dans notre travail ne diffèrent pas de ce qui est décrit dans la littérature. Les risques inhérents à la position pelvienne fréquente ainsi que les possibilités de complications urologiques justifient un dépistage précoce et une surveillance à visée préventive

Paediatric urologic pathologies at the national teaching hospital in Cotonou: an etiological and therapeutic aspects

BACKGROUND: Urological pathologies of children are dominated by congenital malformations of the kidneys and urinary tract. Their management is often surgical. The objective of this survey was to study etiological and therapeutic aspects of urological presentations in children. PATIENTS AND METHODS: Data for aetiology, treatment, and results in children hospitalized at the Paediatric Surgery service of National Teaching Hospital (CNHU) in Cotonou were retrospectively analyzed from January 1999 to December 2008. RESULTS: A total of 214 patients with complete data were evaluated. Urological pathologies represented 4.8% of the hospitalizations in paediatric surgery, with an incidence of 21 cases per year. The mean age was 4.9 ± 3.2 years (age 1 week to 14 years). The male to female ratio was 14:14. Cryptorchidism, hydrocele, nephroblastoma, the posterior urethral valves, ureteropelvic junction obstructions, post-circumcision haemorrhage and hypospadias were the most frequent pathologies. Congenital urological malformations represented 81.3%, followed neoplastic pathologies (7.9%), traumatic pathologies (6.1%) and others (4.7%). The disorders of male genitalia were more frequent and constituted 68.2% of the cases. The anomalies of the urinary tract were 30.8% and intersex disorders were 0.9%. The average age of the children urological pathologies at the time of consultation was 8.85 ± 4.6 years. The treatment was often surgical with a mortality of 2.8%

Evaluation de la qualité des soins et services à la clinique d'urologie et d'andrologie du CHU Hubert Maga de Cotonou

Objectif: L'évaluation de la qualité des soins et services dans la pyramide sanitaire est indispensable et intégrable aux normes et standards de santé des centres hospitaliers. Le but de ce travail est d'apprécier la qualité des soins et services à la Clinique d'Urologie et d'Andrologie de Cotonou. Matériel et méthodes: Le matériel d'étude utilisé est constitué par l'équipement et les prestataires de services de la Clinique d'Urologie et d'Andrologie du CHU Hubert MAGA de Cotonou. La méthode d'étude est rétrospective. La période couverte va du 1er Janvier 2001 au 31 Décembre 2002. L'hypothèse à corréler est « l'amélioration de la qualité des soins et services passe par l'évaluation des services ». Les variables étudiées sont celles du référentiel de l'OMS. Résultats: Les normes et standards évalués à la clinique d'Urologie et d'Andrologie du CHU Hubert MAGA de Cotonou affichent des indicateurs de satisfaction variable. Les indicateurs à améliorer sont les infrastructures (44%< S <72%), le matériel médico-technique (S=75%) et l'utilisation du service (S= 50%). Les autres ont un score 65%<S<100% jugés satisfaisants. Discussion: Les normes et standards évalués sont ceux du référentiel de l'OMS. Ainsi, l'équipement dénote d'une insuffisance d'infrastructure, de matériel médico-technique, de médicaments et de consommables. La performance du personnel est satisfaisante pour sa disponibilité et sa compétence technique. L'efficacité est moyenne quant à l'utilisation de services et suffisante pour les résultats de l'évolution. L'efficience est également moyenne quant au taux d'utilisation du bloc opératoire et à la productivité. L'organisation du service est satisfaisante dans son mécanisme de gestion et dans son organisation opérationnelle. La collaboration interpersonnelle est excellente entre prestataires et utilisateurs de services. L'hygiène est satisfaisante, l'hébergement est acceptable. La restauration répond à l'attente des utilisateurs et des prestataires. Conclusion: Tous les aspects des normes et standards de santé ne sont pas abordés. Les résultats obtenus sont propres au service, à son orientation future dans la stratégie et la tactique de l'assurance qualité de soins. Oui, les normes et standards influencent la qualité des soins et services

Paediatric urological trauma at Nwewi; South Eastern Nigeria : a two-year experience

Objectives: To evaluate the factors implicated in paediatric urologic trauma at Nnamdi Azikiwe University Teaching Hospital (NAUTH); Nnewi; and to determine how these factors could influence the management. Patients and Methods: All medical cases of paediatric urological trauma managed at NAUTH between January 1st; 2000 and December 31st; 2001 were analyzed retrospectively on the basis of the patient records. The patient group included neonates up to children aged 15 years. Apart from the biodata; the cause of the trauma; the organ(s) injured; the treatment given and its outcome were critically analyzed. Results: In the two years under review; 257 cases of paediatric trauma were managed. Out of these; urological trauma was found in 18 patients (7) with a male/female ratio of 5:1 (15 males and 3 females). The commonest causes of paediatric urological trauma in our environment were found to be circumcision mishaps followed by road traffic accidents (RTA) caused by commercial motorcyclists. Treatment was mainly surgical. There was no mortality but we recorded morbidity in four cases (22.2). Conclusion: Our study shows that most of our paediatric urological trauma is preventable. We conclude that paediatric urological trauma in our environment would be drastically reduced if there were laws stipulating that circumcisions should only be done by qualified personnel and if the existing traffic laws of the country were strictly enforced

Social Aspect of Urological Practice in this Country

"Disease in an individual has personal and immediate family stress and certainly has undesirable effects on the socio-economic health of the country. Urological diseases share this general attribute but have peculia characteristics that make it stand out. Most of the patients seen in the urological clinic are senior citizens; towards the evening of their lives. The majority present with urinary tract obstruction from either disease of the prostate or lower urinary tract narrowing from scarring due to infection or trauma (urinary stictures). This touches an area of significant sensitivity from the cultural point of view. Most societies in our country lead a puritan image to old age; thus patients with genitourinary complaints sometimes fear to present themselves lest they are regarded as having venereal diseases. Genitalia are also accorded awesome privacy and mentioning the genetal parts in public is regarded as taboo and in some cases a breach of this etiquette was punishable in some of our societies. Disease of these parts therefore is presented to the medical personnel with a lot of reluctancy and this is compounded by the fact that the sufferers are in most cases dependent socio-economically thus lacking the priviledge of presenting themselves to their doctors without involving a third party who would normally facilitate treatment. Urology disease is mainly a problem of the elderly with rather reduced physiological reserves; their treatment calls for extensive clinical examination and widely varied laboratory investigations. This is aggravated by the late manner of presentation with complications; thus rendering the whole work up a very expensive affair. In the developed world; prostate enlargement with symptoms is regarded as a ""quality of life"" disease but in the third world where it presents with late complciations it is a ""life threatening"" disease; therefore; requiring more extensive investigation. This highlights the irony of the poor paying more than the rich."

Utcome of urethral stricture treated by direct vision urethrotomy in Mulago Hospital

Sixty patients were treated for urethral stricture by direct urethrotomyt during one year at Mulago Hospital; Kampala. Six patients were excluded from the study. Of the remaining 54 patients; 47(87) had an acceptable outcome