Analysis of surgical emergencies in Benghazi, Libyan Arab Jamahiriya

The increasing incidence of trauma due to road crashes and violence has increased the need for an efficient emergency medical service. This cross-sectional study was based in a surgical emergency care facility in Benghazi city, Libyan Arab Jamahiriya. A representative sample of 391 admissions and 492 deaths was drawn from hospital medical records over a 6-year period [2000-05]. A higher proportion of patients were males among both deaths and admissions. Surgical emergencies for females were less serious and less likely to be fatal. The most vulnerable age for admissions was 25-49 years [37.6%] and for deaths was 60+ years [37.0%]. Noncommunicable diseases were responsible for 50.0% of deaths and 61.6% of admissions; the remainder were classified as injuries. The causes of surgical emergencies not only highlight priority areas for hospital management but also have relevance for community health management

Tension-free vaginal tape for the treatment of female stress urinary incontinence: Two-year follow-up

To evaluate the efficacy and two-years follow-up of tension-free vaginal tape [TVT] procedure in the treatment of stress urinary incontinence [SUI]. The study included 25 female patients with SUI with a mean age of 41.6 years. The diagnosis was based upon history, physical examination, 2 days voiding diaries, vaginal examination, stress test and urodynamics. The procedure was performed under local, spinal or general anesthesia and according to Ulmsten, where polypropyline tape is placed in a U-shaped manner around the midurethra without any tension. Cystoscopy was performed to make sure that the bladder is not injured. Urethral catheter was fixed for 12 hours and the patient was discharged in the next day. The mean operative time was 30 minutes [range 20 - 48]. lntraoperative bladder perforation, profuse vaginal bleeding and convulsion were recorded in 3 cases. Early retention, within one week, occurred in 4 patients [16%] who successfully managed and the patients resumed normal voiding. Two patients [8%] developed denovo detrusor instability. Up to 2 years, there was no change in the postoperative outcome and the results seemed to be constant with time. Finally, 21 patients [84%] cured, 2 patients [8%] significantly improved, while the procedure failed in 2 patients [8%]. TVT is a simple and minimally invasive technique. The results of 2 years follow up are encouraging, however the procedure is not a risk free and in developing countries like Egypt, it is relatively expensive