Epidemiological features of prostate cancer in the Republic of Guinea

To define the epidemiological features of prostate cancer in the Republic of Guinea. This retrospective study was carried out in the Department of Urology and Andrology of Conakry University Hospital between January 2000 and December 2006. The parameters studied were the incidence of prostate cancer, the patients' age at the time of diagnosis, as well as the patients' geographical origin, social level, profession, marital status and urological history. Data are presented as mean values, range and percentage. In total, 3895 men were hospitalized at our Department of Urology during the study period. Of these, 5% were treated for prostate cancer. We noted a marked yearly increase of the number of cases with a mean incidence of 29 cases per year. Our patients' mean age was 70.3 [range 52 - 91] years. The majority of our patients originated from the coastal region [46%, n = 93], while only few came from Upper Guinea and the forest areas. Farmers formed the largest socio-professional group in our study, namely 51.2% [n = 104]. The majority of our patients were polygamous [70.4%]. Ninety-four patients reported a history of purulent urethritis. Although several possible risk factors, such as age, exposure to carcinogenic products at work, and sexual predisposing factors [especially sexually transmitted infections [STI]] have been suggested in this study, none of them has been proven to be responsible for the development of prostate cancer. Therefore, studies on large patient groups will be necessary to confirm these theories

Treatment of upper urinary tract calculi at the University Hospital of Conakry: retrospective analysis of 54 cases

To study the diagnostic and therapeutic aspects of upper urinary tract calculi at a hospital in Guinea taking into consideration the local working conditions. This retrospective study included 52 patients with a total of 54 urinary tract calculi treated between January 1, 1994 and December 31, 2003. The parameters studied included the presenting symptoms, the findings on clinical and laboratory investigations and the methods of treatment. The patients' mean age was 37.5 [range 13 - 76] years with a preponderance of the age group of 21 - 30 years, representing 26.9% [n = 14] of the cases. The male-to-female ratio was 10:3. The socio-economic groups most affected by upper urinary tract calculi were farmers and housewives. Pain was the most frequent presenting symptom seen in 92.3% of the patients. The average time between onset of symptoms and presentation was 35 months. Urine microscopy and culture revealed infection in 46 patients [88.5%]; organisms were isolated in 42 cases [80.8%], the majority were Proteus mirabilis, E. coli and Streptococci in 45.2%, 33.3% and 21.4% of the cases, respectively. Intravenous urography [IVU] helped in the diagnosis in 81.5% cases [n = 44]. Treatment consisted of surgery in 96.2% [n=50] of the patients, while 3.8% [n=2] were treated conservatively. After a mean follow-up of 34 months, the results are satisfactory with a pain- and stone-free rate of 82.7% [n=43]. The diagnosis of upper urinary tract calculi is easy. However, we have noted a considerable delay in treatment due to the lack of equipment in our technical environment leading to considerable morbidity and prolonged hospitalization of the patients

[Bilharzial prostatitis: a case report and review of the literature]

Male genital lesions due to Schistosoma haematobium are rare in our environment. However, they were already reported by Chaker in 1889 and by Lortet and Vialleton who described the first lesions in seminal vesicles. We herein describe one case of schistosomal prostatitis discovered accidently in a 65-year-old patient after transurethral resection

[Traumatic rupture of the posterior urethra. Analysis of 87 cases at the Conakry University Hospital]

To report on our experience in the management of traumatic rupture of the posterior urethra. Eighty-seven patients with traumatic rupture of the posterior urethra were treated at the Department of Urology and Andrology of the Conakry University Hospital between January 1988 and December 2004. Trauma was caused by a car accident in 68 [78.2%] and by 72 hours after the accident. The others presented at a stage where urethral structure had already developed. Pelvic fracture was observed in 56 [64.4%] patients. The predominant presenting symptom was urinary retention in 62 [71.3%] patients, followed by bleeding per urethram in 59 [67.8%] and perineal hematoma in 23 [26.4%] patients. Treatment consisted of immediate realignment with a guiding catheter, deferred urethroplasty between the 8th and 10th day, or delayed urethroplasty, depending on the time elapsed after the injury. Good results were achieved in 32 [36.8%] and satisfactory results in 29 [44.8%] cases. Erectile dysfunction was noted in 19 [21.8%] patients. Treatment of ruptures of the posterior urethra remains controversial. Due to the fact that in our environment endoscopic realignment is not possible, deferred emergency end-toend urethrorraphy remains the method of choice for ruptures not associated with other serious lesions. In case of associated serious injuries, these are given priority as a life-saving measure before urethral repair

[Clinical features of cancer of the prostate in Guinea. Results of a study covering the period between 2000 and 2006]

To describe the clinical features of prostate cancer in a Guinean population. This retrospective study was carried out at the Department of Urology and Andrology of the Ignace Deen University Hospital, Conakry, between January 2000 and December 2006. In total, 203 patients were included in the study. The following parameters were evaluated: the patients' age at diagnosis, the reasons for consultation, the findings on digital rectal examination [DRE], total PSA value, prostate volume on ultrasound, tumor stage according to the 2002 TNM classification and Gleason score. The statistical evaluation aimed at finding significant relationships among the collected parameters. The mean patient age was 70,3 years [range: 52 -91 years]. The presenting symptoms consisted of irritative and obstructive urinary symptoms in 96.3% of the cases. DRE suggested malignancy of the prostate in 600% of the patients. The mean PSA value was 120.8 ng/m1 [range:0.1 - 6354 ng/ml]. The mean prostate volume on ultrasound was 77.2 cc. Localized tumors [T1 andT2] were found in21.2% of the patients, with a preponderance of T2 tumors [18.2%], and well differentiated tumors in 44.8% of the patients. The knowledge of these clinical features allows better understanding of the necessity for early diagnosis of prostate cancer in Guinea. Men should be evaluated starting from the age of 50 in order to reduce mortality

[Squamous cell carcinoma of the penis. Report of two cases in CHU of Conakry]

Based on two cases, the authors review the literature and discuss the difficulties of treatment of advanced-stage penile cancer. Two male circumcised patients [age:32 and 46 years] presented with invasive penile carcinoma. In both patients, clinical examination revealed large, infected penile tumors with a healthy stump of less than 5 cm. Superficial inguinal adenopathy and HIV-positivity were found in one of the patients. Both patients were subjected to total penectomy with perineal urethrostomy and antibiotic treatment