ABSTRACT
Introduction: urological emergencies are critical situations that require rapid response by a qualified urology health care professional. The purpose of this study was to highlight the profile of urological emergencies in two university hospitals in the city of Douala by assessing emergency management. Methods: we conducted a retrospective study of the urological emergencies in two reference hospitals in the city of Douala: the Laquintinie Hospital and the General Hospital. Files were collected over a period of 5 years (January 1st, 2016 to December 31st, 2020). All emergency consultations in the Emergency Unit as well as all clinical and therapeutic data from the on-call list during the study period were included. We excluded all emergencies (consultations during the study period) not recorded in the emergency registry. Results: we conducted a study of 364 patients with an average age of 43 ± 8.34 years; 92.58% (n=337) of patients were male. The most common urological emergencies included: urinary retention (45.05%, n=164), renal colic (15.33%, n=56) and haematuria (13.18%, n=48). The most common cause of urinary retention was prostate tumors, renal colic was mainly due to renal lithiasis (96.45%, n=159) and hematuria was due to tumor in 68.75% (n=33) of patients. Therapeutic management was based on urinary catheterization (39.01%, n=142), medical treatment was associated with monitoring (27.47%, n=100) and suprapubic cystostomy (10.71%, n=39). Conclusion: acute urinary retention due to prostate tumors is the most common urological emergency in the university hospitals in the city of Douala. Early and optimal management of prostate tumors is therefore essential.
Subject(s)
Prostatic Neoplasms , Renal Colic , Urinary Retention , Urologic Diseases , Humans , Male , Adult , Middle Aged , Hospitals, University , Urologic Diseases/diagnosis , Urologic Diseases/epidemiology , Urologic Diseases/therapy , Retrospective Studies , Emergencies , Cameroon , HematuriaABSTRACT
Introduction: les urgences en urologie sont des situations urologiques critiques qui nécessitent une intervention rapide par un professionnel de santé qualifié en urologie. Cette étude a été menée dans le but de ressortir le profil des urgences urologiques reçues dans deux hôpitaux universitaires de la ville de Douala en appréciant leurs prises en charge en urgence. Méthodes: il s´agit d´une étude rétrospective portant sur les urgences urologiques dans deux hôpitaux de références de la ville de Douala que sont les hôpitaux Laquintinie et Général de Douala. Les dossiers ont été colligés durant une période de 5 ans (1er janvier 2016 au 31 décembre 2020). Nous avons inclus toutes les consultations effectuées en urgence et reçues par le service des urgences ainsi que toutes les données cliniques et thérapeutiques venant du registre de garde durant la période d´étude. Nous avons exclu de notre étude toutes les urgences (consultations reçues pendant la période d´étude, non relevées dans le registre des urgences) Résultats: nous avons étudié 364 patients, l´âge moyen des patients était de 43 ± 8,34 ans. Quatre vingt-douze virgule cinquante huit pourcent (92,58%) (n=337) des patients étaient des hommes. Les principales urgences urologiques reçues étaient la rétention d´urine vésicale (45,05%, n=164), la colique néphrétique (15,33%, n=56) et l´hématurie (13,18%, n=48). Les principales étiologies des rétentions d´urine vésicale étaient les tumeurs prostatiques, la colique néphrétique était principalement d´origine lithiasique (96,45%, n=159) et l´hématurie était d´origine tumorale chez 68,75%(n=33) des patients. Sur le plan thérapeutique, les gestes effectués en urgence étaient le sondage vésical (39,01%, n=142), le traitement médical était associé à une surveillance (27,47%, n=100) et la cystostomie sus pubienne (10,71%, n=39). Conclusion: les rétentions aigues d´urines vésicales sur tumeurs prostatiques constituent l´urgence urologique la plus fréquente dans les hôpitaux universitaires de la ville de Douala. Cela implique une prise en charge précoce et optimale des tumeurs prostatiques.
Subject(s)
Prostatic Neoplasms , Therapeutics , Urology , Cystostomy , Emergencies , HematuriaABSTRACT
INTRODUCTION AND IMPORTANCE: Retrocaval ureter (RCU) is a rare congenital anomaly usually associated with upper urinary tract stasis, in which the ureter itself passes behind the inferior vena cava. RCU is often misdiagnosed and can lead to serious complications related to the upper urinary tract stasis. CASE PRESENTATION: We report the case of a 57-year-old female who presented with 1-year history of intermittent right flank pain, of gradual onset. She was diagnosed with right RCU, with advanced functional deterioration of the kidney, managed by nephrectomy. The postoperative course was uneventful. CLINICAL DISCUSSION: RCU results in varying degrees of hydronephrosis and thus, in a non-specific clinical presentation. Most cases are asymptomatic, discovered only during imaging or surgery for unrelated conditions or at autopsy. A late diagnosis can lead to an obstructive nephropathy which can be very harmful to the kidney. CONCLUSION: RCU is a very rare entity. The diagnosis can sometimes be late in under-medicalized settings, and must be taken into consideration in front of any hydronephrosis associated or not with intermittent flank pain. RCU-related complications can be very serious. Fish hook sign may be absent in case of nonfunctional kidney and must not exclude the diagnosis. Emphasis should be placed on prenatal diagnosis and routine abdominal ultrasound for early detection.
