[Acute priapism associated with sickle cell disease in Senegal: clinical, therapeutic features and risk factors for erectile dysfunction]. / Priapisme aigu chez les drépanocytaires sénégalais: aspects cliniques, thérapeutiques et évaluation de la fonction érectile.

UNLABELLED: To describe clinical and therapeutic features of ischemic priapism associated with sickle cell disease (SSD) in Senegalese men and to identify risk factors for erectile dysfunction (ED). PATIENTS AND METHODS: The charts of all patients admitted to the Urology Department of Aristide Le Dantec University Teaching Hospital (Dakar) for ischemic priapism associated with SSD between January 2000 and September 2008 were retrospectively reviewed. RESULTS: A total of 22 patients with a mean age of 19.5 +/- 9.9 years (6 - 41 years) were identified. The most affected age group was between 21 and 30 years. The mean duration between onset of the episode and admission was 89.6 +/- 103.1 hours (4 - 384 hours). Nine patients (40.9%) were admitted within 24 hours after the onset. Eight patients (36.3%) had a history of stuttering priapism. The sickle cell phenotype identified by electrophoresis was SS in 18 patients and AS in four. The main treatment modalities were corporeal aspiration that was performed with or without intracavernosal injection of sympathomimetics drugs and Al Ghorab shunt surgery that was used in ten patients with a success rate of 90 % (complete detumescence). With a mean follow-up of 3.8 +/- 1.5 years, nine (69.2%) of the 13 patients older than 16 years developed ED. The incidence of ED was significantly correlated with the duration of the priapism but not with SSD phenotype. CONCLUSION: In Senegal ischemic priapism associated with sickle cell disease occurs mainly in young people. The incidence of ischemic priapism appears to be low but ED is common due to the prolonged duration of priapism.

[Malignant melanoma in the Ivory Coast. Epidemiologic and histo-prognostic aspects. Report of 195 cases]. / Mélanomes malins en Côte-d'Ivoire aspects épidémiologiques et histopronostiques. A propos de 195 cas.

Malignant melanomas (MM) are rare tumors of very bad prognosis. Few studies have precised the anatomopathological aspects and prognosis of these tumors in Africa and especially in Côte d'Ivoire. This has prompted us to review 195 cases of MM diagnosed in our laboratories in order to precise their epidemiological and anatomical features. Biopsies and/or surgical specimens fixed in 10% buffered formalin have been studied using the paraffin embedding methods and staining with hematoxylin and eosin, Masson's trichrome and Fontana. 117 men (60%) and 78 women (40%) with a medium age of 57 years were studied. Cutaneous MM were predominant (174 cases, 93%) with 57.8% located on the foot. Non classified (38.2%) and nodular (33.6%) forms were more frequent with only 19% of acral lentiginous melanomas. The prognosis of our cases was poor with 71% of levels IV or V according to Clark and Mihm, Breslow's thickness superior to 3 mm in 93% of cases and ulceration in 91.3%. Our study emphasizes the poor prognosis of MM in Côte d'Ivoire. These tumors are frequent in the elderly and located predominantly on the foot.