One-stop haematuria clinic: first experience in South Africa

Background. Haematuria is the most common symptom of urological cancers, specifically bladder cancer, and timely diagnosis can prevent disease from progressing to a more advanced or incurable stage. One-stop haematuria clinics (OSHCs) have become commonplace in urological services in developed countries during the past three decades.Objectives. To assess the efficacy of this specialised clinic, aimed at providing an investigative service for patients with haematuria, in decreasing morbidity and mortality by earlier diagnosis of urological malignancy. We also report on the outcomes of this study.Methods. A total of 275 patients who attended the weekly OSHC at Groote Schuur Hospital, Cape Town, South Africa (SA), between January 2012 and October 2015 were retrospectively included in the study (out of 477 folders reviewed). Only patients with visible haematuria (275/477) were included, and characteristics such as gender, age, self-identified ethnicity, and outcomes following OSHC attendance (diagnoses and stage/grade/type of cancers) were recorded.Results. While the majority of cases were classified as indeterminate following investigation, one-fifth (55/275) of the patients were diagnosed with urological neoplasms, mainly bladder cancer (87.2%, n=48). The 50 - 69-year age group was the most common window for diagnosis of a neoplasm. Forty-six patients (46/55) with urothelial cancers were diagnosed at a relatively early stage and were therefore offered curative management; 5 patients presented with late-stage disease and risked poor outcomes after management. The remaining 4 identified cases were adenocarcinomas and squamous cell carcinomas. Most patients presented with high-grade cancers (43.2%). A small subset of patients were diagnosed with renal cell carcinoma (11.6%) and upper-tract transitional cell carcinoma (1.6%).Conclusions. This audit revealed that an OSHC can streamline diagnosis of urological malignancies in the SA setting, and highlights the fact that the patients most at risk for developing malignant conditions were the ones frequently diagnosed at a later stage and hence potentially facing a poorer prognosis. These findings support the setting up of such clinics in other SA hospitals to improve ease of early access to the urological service

Panorama des tumeurs urologiques au CNHU-HKM de Cotonou

Introduction : Les tumeurs urologiques sont très fréquentes dans la pratique courante de l'Urologie et constitue l'essentiel de l'activité de l'urologue Objectifs : Etudier les aspects épidémiologiques et évolutives des tumeurs urologiques à la Clinique Universitaire d'Urologie-Andrologie du CNHU HKM de Cotonou Patients et Méthodes : Il s'agissait d'une étude rétrospective et descriptive des aspects épidémiologiques et évolutives des tumeurs urologiques reçues au CNHU-HKM de Cotonou sur la période allant du 1er janvier 2008 au 31 décembre 2017. Les paramètres étudiés étaient : l'âge, le sexe des patients, le diagnostic, la localisation et la nature suspectée de la tumeur, le délai de recours aux soins et la mortalité hospitalière. Résultats : 1047 dossiers ont été colligés. La majorité (82,14%) de nos patients ont un âge supérieur à 50 ans. Les hommes sont majoritairement atteints avec un taux de 92,36%. La sex-ratio est de 0,92 en faveur des hommes H/F. La majorité de nos patients (87,68%) avait vu leurs symptomatologies évoluer plus de 6 mois avant de recourir aux soins médicaux. Un total de 532 patients avait une tumeur bénigne et 515, une tumeur maligne. La glande prostatique est l'organe génital masculin le plus affecté. Les tumeurs prostatiques représentent 75, 54% des tumeurs uro-génitaux dont 43,83% bénignes et 31,70% malignes. Conclusion : Les tumeurs urogénitales sont des affections fréquentes dominées par les tumeurs de la prostate, de la vessie et des reins. Au Bénin, elles sont diagnostiquées tardivement

Panorama des tumeurs urologiques au CNHU-HKM de Cotonou

Introduction : Les tumeurs urologiques sont très fréquentes dans la pratique courante de l'Urologie et constitue l'essentiel de l'activité de l'urologue Objectifs : Etudier les aspects épidémiologiques et évolutives des tumeurs urologiques à la Clinique Universitaire d'Urologie-Andrologie du CNHU HKM de Cotonou Patients et Méthodes : Il s'agissait d'une étude rétrospective et descriptive des aspects épidémiologiques et évolutives des tumeurs urologiques reçues au CNHU-HKM de Cotonou sur la période allant du 1er janvier 2008 au 31 décembre 2017. Les paramètres étudiés étaient : l'âge, le sexe des patients, le diagnostic, la localisation et la nature suspectée de la tumeur, le délai de recours aux soins et la mortalité hospitalière Résultats : 1047 dossiers ont été colligés. La majorité (82,14%) de nos patients ont un âge supérieur à 50 ans. Les hommes sont majoritairement atteints avec un taux de 92,36%. La sex-ratio est de 0,92 en faveur des hommes H/F. La majorité de nos patients (87,68%) avait vu leurs symptomatologies évoluer plus de 6 mois avant de recourir aux soins médicaux. Un total de 532 patients avait une tumeur bénigne et 515, une tumeur maligne. La glande prostatique est l'organe génital masculin le plus affecté. Les tumeurs prostatiques représentent 75, 54% des tumeurs uro-génitaux dont 43,83% bénignes et 31,70% malignes. Conclusion : Les tumeurs urogénitales sont des affections fréquentes dominées par les tumeurs de la prostate, de la vessie et des reins. Au Bénin, elles sont diagnostiquées tardivement

Urological Malignancies in Port Harcourt; Nigeria: a 14-Year Review

Background: Urological malignancies are complex; covering the urinary system in both sexes and the genital system of males. They are common in this setting and posing a lot of problems to the patients. In most cases; the disease terminates in the death of the patient. Aim: To study the pattern and frequency of urological malignancies. Methods: All the urological tissues histologically diagnosed as malignant at the University of Port Harcourt Teaching Hospital; Port Harcourt; Nigeria between 1990 and 2003 were retrospectively studied. Variables such as the age and sex of the patients; anatomical site of the cancer; laterality of the tumours; clinical presentation and the histological types were obtained from the theatre operation register; patient's case notes; histology request forms; reports and autopsy reports. Results: There were 270 histologically confirmed urological malignancies during the period under review. This accounted for 11.3of the total malignancies and affected all ages of both sexes with a male to female ratio of 9.8:1 . The 70 years and above age group were most affected [103(38.1)] and carcinoma of the prostate was the most frequent [189(70.0)]. Adenocarcinoma of the prostate gland was the leading histological variant [187(64.0)] and urinary outflow obstruction was the most common clinical presentation [62(23.0)]. Conclusion: Urological malignancies are fairly common in this environment and carcinoma of the prostate gland is dominating

The Pattern of Urological Cancers in Zambia

Objective: To examine the pattern of urological malignancies; particularly cancer of the bladder; seen at the University Teaching Hospital (UTH) in Lusaka and to compare the findings with previous studies on the same parameters done at UTH. Material and Methods: A retrospective study of urological cancers in Zambia was performed; based on histopathology reports of specimens reviewed at the UTH Pathology Laboratory in Lusaka; Zambia; between January 1990 and December 2005. The parameters studied were the histological type of the cancer; patient age and trends over a 15-year period. Results: In total; 8829 cancers were diagnosed during the study period; of which 749 (8.5) were urological malignancies affecting the kidney; bladder; prostate; testis or penis. The maleto- female ratio of the urological cancers was 10.7 to 1. Cancer of the prostate was the most common urological malignancy (54.6); followed by bladder cancer (21.1) and penile cancer (18.6). The histological type of bladder cancer was mainly squamous cell carcinoma (46.2); transitional cell carcinoma (23.4) and adenocarcinoma (22.2); other types (8.2) included rhabdomyosarcoma; small cell carcinoma and lymphoma. The majority of patients (79) with bladder cancer were between 56 and 65 years of age. Whereas 20 years ago prostate cancer comprised only 26of urological malignancies; it accounted for 55of urological cancers diagnosed in Zambia between 1990 and 2005. In contrast; cancer of the penis; kidney and testis have shown no change in frequency distribution compared to 20 years ago. Conclusion:Over the last 15 years there has been an increasing proportion of cancer of the prostate and squamous cell carcinoma of the bladder. This is associated with high levels of schistosomiasis; cystitis (some of which is HIV-related) and bladder stones. It may also be due to the extension of urological services and the diagnostic armamentarium (PSA; cystoscopy and histological diagnosis) to indigent rural populations; where the incidence of squamous cell carcinoma is likely to be higher than in affluent urban populations

The Changing Pattern of Urological Cancers in Zambia

The university teaching hospital Lusaka (UTH) is the main reference hospital and national reference laboratory in Zambia it has a referral areas of 1.3 million people objectives :the purpose of the study was to examine the pattern of urological malignancies seen at the UTH in Lusaka .in particular the pattern of cancer of the bladder. Method :A retrospective study of urological cancers in Zambia was done ; which the IDC(10) classification .Results: a total 8829 cancers were diagnosed over the 15years study period; 749(8.4) were urological maligical cancer was 10.7 to 1. cancer of the prostate was the most common urological malignancy (54;6) ; followed by cancer of the bladder (21;1) and cancer of the penis (18.6) the histological type of bladder cancer was squamous celle carcinoma (46.2); transitional cell carcinoma (23.4); adenocarcinoma (22;2) and other types (82) . the majority of patients (79) with bladder .cancer were between and 65years of age .There was an increasing incidence of squamous celle cancers of the bladder over last 15 tears.Conclusion:twenty years ago prostate cancer comprised only 26of urological malignancies ;it now makes up 55of the urological cancers diagnosed in Zambia over the last 15 years.In contrast; cancer of the penis; kidney and testis have shown so change in frequency distribution compared to 20 years ago.There has been has an increase in squamous cell type of bladder observed over the last 15 years