Cancer of the cervix in unscreened West African women

Background: Cancer of the cervix remains an important health problem amongst women worldwide. Widespread comprehensive cervical cancer control programs have resulted in a marked reduction in the incidence and mortality in most developed countries. Developing countries bear over 80 of the global burden; with only 5 of the global resources for the control of cancer. Majority of the cases in these countries present late and are incurable at the time of diagnosis. Aim: To review the presentation and histopathological types of cervical cancer cases seen in Aminu Kano Teaching Hospital Kano; over a sixteen-year period (1995-2010). Materials and Methods: Case records of histopathologically diagnosed cases of cancer of the cervix were retrieved. Demographic data; stage of the tumor at presentation; and histopathologic type were extracted. The results were analyzed using descriptive statistics. Results: Six hundred and sixty gynecological cancers were seen during the study period; with cancer of the cervix accounting for 58.5 (386/660) cases. Among these cases with cancer of the cervix 71.1 (275/386) were grand multiparous and majority 89.7 346/386 presented with advanced disease. Squamous cell carcinoma (SCC) accounted for 86.3 (333/386) of the cancers; adenocarcinoma contributed 12.4;(48/386) and others contributed 1.3(5/386). Conclusion: Cancer of the cervix is the commonest gynecological cancer at Aminu Kano Teaching Hospital; Kano; Nigeria. SCC is the commonest histological type

Review of Intrauterine Adhesiolysis at the Aminu Kano Teaching Hospital; Kano; Nigeria

Background: Hysteroscopic adhesiolysis is shown to significantly improve the outcome of intrauterine adhesions (IUA). The Minimally Invasive Surgical Unit (MISU) of our Department recently acquired a hysteroscope which is being used for hysteroscopic adhesiolysis among others. Materials and Methods: There were 57 patients diagnosed to have IUA of which 54 case notes were available for analysis; giving a retrieval rate of 95. The information extracted includes age; parity; and menstrual pattern; predisposing factors; treatment option; outcome; complications and the year of the procedure. The data extracted were analyzed using Epi info Version 3.4.1. Chi squared test (Fisher's exact test) was used to test for statistical difference in the outcome of the modalities of treatment. P value of less than 0.05 was considered significant. Results: There were 57 cases of IUA out of 4160 gynecological patients seen; giving a prevalence of 14/1000. The mean age was 28.9 years (SD 4.5) and mean parity was 1.4 (SD 1.4). Etiologic factors include Dilatation and curettage (D and C) (33.3); Caesarean section (C/S) (31.5); manual removal of placenta and Pelvic Inflammatory Disease (PID) (7.4each); and unexplained (3.7). Mode of presentation was secondary amenorrhoea (50); oligomenorrhoea (22.2); and hypomenorrhoea (10). As for the management; 68had blind procedure while 25.9had hysteroscopic procedure. Lippes loop was used in all except three patients who had pediatric Foleys catheter instead. Upon follow-up 59.3resumed normal menses; 11.1had oligomenorrhoea; hypomenorrhoea 13and amenorrhoea 5.6. There was no statistical difference in the outcome of treatment between hysteroscopic adhesiolysis and the blind procedure when return to normal menses is considered as the end point; OR=2.27; CI 0.45-12.65; Fisher exact test (one-tailed) P=0.2184818. Conclusion: There was no significant difference between the blind and hysteroscopic procedures. Dilatation and curettage was found to be the commonest cause of IUA